THOR Literature watch for November 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM

43 LLLT papers for you this month including: Three systematic reviews with meta-analysis on LLLT 1) before, during and after exercises, 2) frozen shoulder/adhesive capsulitis, 3) subacromial impingement syndrome. ALSO a trial showing increased muscle torque in elite athletes, reduced oral mucositis in pediatric cancer patients, LED for TMJ dysfunction, Laser vs LED dentin hypersensitivity, combined autologous PRP and LED for venous ulcers, LED after eccentric exercise (it seems to be a big month for LEDs ) and delightful editorial from Kevin Moore on the early years for LLLT and the World Association for Laser Therapy (WALT).

Phototherapy effect on the muscular activity of regular physical activity practitioners.

Dos Santos Maciel T, Munoz IS, Nicolau RA, Nogueira DV, Hauck LA, Osorio RA, de Paula Junior AR

Phototherapy and Photobiology Center and Biologic Signal Processing Laboratory, UNIVAP, Sao Jose dos Campos, Sao Paulo, Brazil, macielts@hotmail.com.

Clinical investigations have demonstrated the effectiveness of phototherapy on the muscle activity. The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on the tibialis anterior muscle of regular physical activity practitioners by electromyographic, biomechanical, and biochemical (lactate) analysis. Double-blind controlled clinical trials were conducted with 12 healthy females, regular physical activity practitioners, between 18 and 30 years. The LLLT application (780 nm, 30 mW, 0.81 J/point, beam area of 0.2 cm2, 27 s, approximately 29 points) in the tibialis anterior muscle occurred after the delimitation of the points on every 4 cm2 was held. It was observed that (a) a significant torque increase (p < 0.05) post-LLLT compared to the values after placebo therapy at the beginning of resistance exercise, (b) both muscle torque (isokinetic) and median frequency (EMG) showed a faster decay of the signals collected after placebo and laser treatment when compared to control values, (c) no significant change in torque in the strength test of five repetitions, (d) a significant muscle activity decrease (p < 0.05) after laser therapy compared to control values, and (e) an increase in lactate levels post-LLLT (p < 0.05) after 30 min of exercise. It is concluded that the LLLT increased the muscle torque at the beginning of the exercise and maintained the levels of lactate after resistance exercise. Therefore, the LLLT with the parameters used in this study can be utilized in rehabilitation to improve muscle performance in elite athletes.

Lasers Med Sci 2013 Nov 28

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24288083

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Low-level laser in prevention and treatment of oral mucositis in pediatric patients with acute lymphoblastic leukemia.

de Castro JF, Abreu EG, Correia AV, da Mota Vasconcelos Brasil C, da Cruz Perez DE, de Paula Ramos Pedrosa F

1 Postgraduate Program in Dentistry, Oral Pathology Unit, Federal University of Pernambuco , Recife, Pernambuco, Brazil .

Abstract Objective: The aim of this study was to evaluate the influence of low-level laser therapy (LLLT) on the prevention and treatment of oral mucositis (OM) in pediatric cancer patients taking methotrexate. Background data: OM is a very common, potentially severe side effect, caused by treatment with radiotherapy and chemotherapy for cancer. Methods: Forty patients with acute lymphoblastic leukemia, who received high doses of methotrexate, were distributed into two groups. Group A (Preventive Group) was composed of patients who received preventive laser (red-subgroup A1 or infrared-subgroup A2) for 5 days, beginning on the 1st day of infusion. Group B (Treatment Group) was composed of patients who received laser treatment only if they developed post-chemotherapy mucositis (red-subgroup B1 or infrared-subgroup B2). Laser was used at wavelengths of 660 or 830 nm with output 100 mW, power density 3.57 W/cm(2), spot size 0.028 cm(2), energy of 1 J, resulting in an energy density of 35 J/cm(2) for 10 sec in the prophylactic group, and energy of 2 J, resulting in energy density of 70 J/cm(2) for 20 sec in the therapeutic group. Results: The percentage of patients who did not develop OM was higher in Group A (60% vs. 25%). In Group B, 3/20 patients developed grade IV OM (15%), and a significant difference was found between the two subgroups at the end of treatment (p=0.019). Conclusions: Prophylactic laser produced a better outcome than when patients did not receive any preventive intervention, and red laser (660 nm) was better than infrared (830 nm) in the prevention and treatment of OM.

Photomed Laser Surg 2013 Dec 31(12) 613-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24261310

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Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis.

Leal-Junior EC, Vanin AA, Miranda EF, de Carvalho PD, Dal Corso S, Bjordal JM

Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Rua Vergueiro, 235, 01504-001, Sao Paulo, SP, Brazil, ernesto.leal.junior@gmail.com.

Recent studies have explored if phototherapy with low-level laser therapy (LLLT) or narrow-band light-emitting diode therapy (LEDT) can modulate activity-induced skeletal muscle fatigue or subsequently protect against muscle injury. We performed a systematic review with meta-analysis to investigate the effects of phototherapy applied before, during and after exercises. A literature search was performed in Pubmed/Medline database for randomized controlled trials (RCTs) published from 2000 through 2012. Trial quality was assessed with the ten-item PEDro scale. Main outcome measures were selected as: number of repetitions and time until exhaustion for muscle performance, and creatine kinase (CK) activity to evaluate risk for exercise-induced muscle damage. The literature search resulted in 16 RCTs, and three articles were excluded due to poor quality assessment scores. From 13 RCTs with acceptable methodological quality (>/=6 of 10 items), 12 RCTs irradiated phototherapy before exercise, and 10 RCTs reported significant improvement for the main outcome measures related to performance. The time until exhaustion increased significantly compared to placebo by 4.12 s (95 % CI 1.21-7.02, p < 0.005) and the number of repetitions increased by 5.47 (95 % CI 2.35-8.59, p < 0.0006) after phototherapy. Heterogeneity in trial design and results precluded meta-analyses for biochemical markers, but a quantitative analysis showed positive results in 13 out of 16 comparisons. The most significant and consistent results were found with red or infrared wavelengths and phototherapy application before exercises, power outputs between 50 and 200 mW and doses of 5 and 6 J per point (spot). We conclude that phototherapy (with lasers and LEDs) improves muscular performance and accelerate recovery mainly when applied before exercise.

Lasers Med Sci 2013 Nov 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24249354

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Comparative clinical study of light analgesic effect on temporomandibular disorder (TMD) using red and infrared led therapy.

Panhoca VH, de Fatima Zanirato Lizarelli R, Nunez SC, Pizzo RC, Grecco C, Paolillo FR, Bagnato VS

Optics Group from Physics Institute of Sao Carlos (IFSC), University of Sao Paulo (USP), Brazil. Av. Trabalhador Sancarlense, 400-Centro, 13560-970, Sao Carlos, SP, Brazil, vhpanhoca@msn.com.

Low-level laser therapy (LLLT) has been widely applied in pain relief in several clinical situations, including temporomandibular disorders (TMD). However, the effects of LED therapy on TMD has not been investigated. This study aims to evaluate the effects of red and infrared LEDs on: (1) tissue temperature in ex vivo and (2) pain relief and mandibular range of motion in patients with TMD. Thirty patients between 18 and 40 years old were included and randomly assigned to three groups. The two experimental groups were: the red LED (630 +/- 10 nm) group and the infrared LED (850 +/- 10 nm) group. The irradiation parameters were 150 mW, 300 mW/cm2, 18 J/cm2, and 9 J/point. The positive control group received an infrared laser (780 nm) with 70 mW, 1.7 W/cm2, 105 J/cm2, and 4.2 J/point. LED and laser therapies were applied bilaterally to the face for 60 s/point. Five points were irradiated: three points around the temporomandibular joint (TMJ), one point for the temporalis, and one near the masseter. Eight sessions of phototherapy were performed, twice a week for 4 weeks. Pain induced by palpating the masseter muscle and mandibular range of motion (maximum oral aperture) were measured at baseline, immediately after treatment, 7 days after treatment, and 30 days after treatment. There was an increase in tissue temperature during both the red and the infrared LED irradiation in ex vivo. There was a significant reduction of pain and increase of the maximum oral aperture for all groups (p >/= 0.05). There was no significant difference in pain scores and maximum oral aperture between groups at baseline or any periods after treatment (p >/= 0.05). The current study showed that red and infrared LED therapy can be useful in improving outcomes related to pain relief and orofacial function for TMD patients. We conclude that LED devices constitute an attractive alternative for LLLT.

Lasers Med Sci 2013 Oct 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24197518

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Clinical evaluation of low-power laser and a desensitizing agent on dentin hypersensitivity.

Lopes AO, de Paula Eduardo C, Aranha AC

Special Laboratory of Lasers (LELO), Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, 05580-900, Brazil, anelyol@gmail.com.

The aim of this randomized, longitudinal clinical study was to evaluate different protocols for dentin hypersensitivity treatment with low-power laser at different dosages, desensitizing agent, and associations, for a period of 6 months. After analysis of the inclusion and exclusion criteria of volunteer participants, those who present pain resulting from non-carious cervical lesions were selected. Twenty-seven patients participated in the study, and 55 lesions were recorded. The lesions were divided into five groups (n = 11), treated, and evaluated: G1: Gluma Desensitizer (Heraeus); G2: low-power laser (Photon Lase, DMC) at low dose (three vestibular points and one apical point of irradiation: 30 mW, 10 J/cm2, 9 s per point with wavelength of 810 nm), three sessions were performed with an interval of 72 h between them; G3: low-power laser at high dose (application at one cervical and one apical point: 100 mW, 90 J/cm2, 11 s per point with wavelength of 810 nm), three sessions were performed with an interval of 72 h between irradiations; G4: low-power laser at low dose + Gluma Desensitizer; and G5: low-power laser at high dose + Gluma Desensitizer, the level of sensitivity of each volunteer was evaluated with a visual analog scale of pain (VAS) with the use of air from a triple syringe and exploration with a probe after time intervals of 5 min, 1 week, and 1, 3, and 6 months after treatment. Data were collected and subjected to statistical analysis. Kolmogorov-Smirnov test was used to verify the distribution of the data, and nonparametric Kruskal-Wallis and Friedman tests were performed for comparison among the experimental groups and time intervals studied, respectively. Statistically significant differences between the studied time intervals (p < 0.05) were detected. From the difference in pain, it was observed that for both stimuli, the protocol with the Gluma desensitizing agent presented immediate effects of pain reduction. For low-level lasers, it was observed that there were distinct effects for the different doses; however, both were efficient in reducing pain up to the 6 months of clinical follow-up. Therefore, it could be concluded that all the desensitizing protocols were effective in reducing dentin hypersensitivity, but with different effects. The combination of protocols is an interesting alternative in the treatment of cervical dentin hypersensitivity.

Lasers Med Sci 2013 Oct 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24197517

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Treatment of refractory venous stasis ulcers with autologous platelet-rich plasma and light-emitting diodes: a pilot study.

Park KY, Kim IS, Yeo IK, Kim BJ, Kim MN

Department of Dermatology, Chung-Ang University, College of Medicine, Seoul, South Korea.

BACKGROUND: Stasis dermatitis with secondary ulcer formation is not only therapeutically challenging but also significantly decreases the quality of life for affected individuals. Recently, autologous platelet-rich plasma (PRP) has entered the therapeutic regimen for leg ulcers, while light-emitting diodes (LEDs) are now used to accelerate wound healing. OBJECTIVE: To assess the efficacy and safety of autologous PRP with concomitant LED therapy for the treatment of venous stasis dermatitis with secondary ulceration. METHODS AND MATERIALS: In total, 16 Korean patients with ulcers secondary to venous stasis dermatitis were enrolled in this study. Each lesion was treated with autologous PRP weakly, and LED therapy three times per week. Treatments continued for 6 weeks or until the ulcer completely reepithelialized without evidence of drainage. Not only were subjects objectively evaluated by a study investigator, their own subjective satisfaction was also assessed. RESULTS: The combined autologous PRP and LED therapy was well tolerated and safe. A statistically significant improvement was observed post-therapeutically in the clinical parameters of pain, itching, heaviness, paresthesia, cramps, and leg swelling. There was also a significant decrease in ulcer size. None of the patients showed worsening of their venous stasis ulcer. Regarding subject satisfaction with the regimen, 75.0% of participants reported being ‘satisfied or very satisfied’ with their overall improvement after treatment. No significant adverse effects were observed. CONCLUSION: Combined autologous PRP and LED therapy is a promising conservative combination regimen for treating recalcitrant ulcerating stasis dermatitis. Additional studies comparing combined autologous PRP and LED therapy directly with autologous PRP or LED monotherapies are needed to confirm the results reported here.

J Dermatolog Treat 2013 Oct 24(5) 332-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23738854

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Light-emitting diode phototherapy improves muscle recovery after a damaging exercise.

Borges LS, Cerqueira MS, Dos Santos Rocha JA, Conrado LA, Machado M, Pereira R, Neto OP

Department of Biological Sciences, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil.

The goal of the present study was to determine the effect of light-emitting diode phototherapy (LEDT) at 630 nm on muscle recovery after a damaging eccentric exercise bout. Seventeen healthy young male volunteers, without previous experience with eccentric exercise, were included in a randomized double-blinded placebo-controlled trial. They were divided into a LEDT (n = 8) and a PLACEBO group (n = 9). To induce muscle damage, subjects performed 30 eccentric contractions with a load of 100 % of maximal voluntary isometric contraction strength of the elbow flexors of the non-dominant arm. LEDT group subjects received biceps brachii phototherapy (lambda 630 nm; total energy density, 20.4 J/cm2) immediately after the exercise bout. The LEDT in the placebo group was aimed at the muscle, but it remained turned off. Isometric muscle strength, muscle soreness, and elbow range of motion (ROM) were measured before and at 24, 48, 72, and 96 h the after eccentric exercise bout and compared between groups. Our results showed that the muscle soreness, muscle strength loss, and ROM impairments were significantly reduced up to 96 h after a damaging eccentric exercise bout for the LEDT group compared with the PLACEBO group. A single LEDT (630 nm) intervention immediately after a damaging eccentric exercise bout was effective in terms of attenuating the muscle soreness and muscle strength loss and ROM impairments.

Lasers Med Sci 2013 Nov 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24258312

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Photomedicine: the early years.

Moore KC

Former Consultant Anaesthetist and Director Pain & Laser Therapy Clinic, The Royal Oldham Haspital , Oldham, UK ; Medical Director and Chief Executive, Dr Kershaw’s Hospice, Oldham, UK; and Honorary Treasurer and Member of Executive Council, World Association for Laser Therapy.

Photomed Laser Surg 2013 Dec 31(12) 563-4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24251929

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The effectiveness of physiotherapeutic interventions in treatment of frozen shoulder/adhesive capsulitis: A systematic review.

Jain TK, Sharma NK

Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.

BACKGROUND AND OBJECTIVE: Frozen shoulder is a common condition, yet its treatment remains challenging. In this review, the current best evidence for the use of physical therapy interventions (PTI) is evaluated.METHOD: MEDLINE, CINAHL, Cochrane, PEDro, ProQuest, Science Direct, and Sport Discus were searched for studies published in English since 2000. RESULTS: 39 articles describing the PTI were analyzed using Sackett’s levels of evidence and were examined for scientific rigor. The PTI were given grades of recommendation that ranged from A to C. CONCLUSIONS: Therapeutic exercises and mobilization are strongly recommended for reducing pain, improving range of motion (ROM) and function in patients with stages 2 and 3 of frozen shoulder. Low-level laser therapy is strongly suggested for pain relief and moderately suggested for improving function but not recommended for improving ROM. Corticosteroid injections can be used for stage 1 frozen shoulder. Acupuncture with therapeutic exercises is moderately recommended for pain relief, improving ROM and function. Electro- therapy can help in providing short-term pain relief. Continuous passive motion is recommended for short-term pain relief but not for improving ROM or function. Deep heat can be used for pain relief and improving ROM. Ultrasound for pain relief, improving ROM or function is not recommended.

J Back Musculoskelet Rehabil 2013 Nov 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24284277

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Subacromial impingement syndrome–effectiveness of physiotherapy and manual therapy.

Gebremariam L, Hay EM, van der Sande R, Rinkel WD, Koes BW, Huisstede BM

Department of General Practice, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.

BACKGROUND: The subacromial impingement syndrome (SIS) includes the rotator cuff syndrome, tendonitis and bursitis of the shoulder. Treatment includes surgical and non-surgical modalities. Non-surgical treatment is used to reduce pain, to decrease the subacromial inflammation, to heal the compromised rotator cuff and to restore satisfactory function of the shoulder. To select the most appropriate non-surgical intervention and to identify gaps in scientific knowledge, we explored the effectiveness of the interventions used, concentrating on the effectiveness of physiotherapy and manual therapy. METHODS: The Cochrane Library, PubMed, EMBASE, PEDro and CINAHL were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently extracted data and assessed the methodological quality. A best-evidence synthesis was used to summarise the results. RESULTS: Two reviews and 10 RCTs were included. One RCT studied manual therapy as an add-on therapy to self-training. All other studies studied the effect of physiotherapy: effectiveness of exercise therapy, mobilisation as an add-on therapy to exercises, ultrasound, laser and pulsed electromagnetic field. Moderate evidence was found for the effectiveness of hyperthermia compared to exercise therapy or ultrasound in the short term. Hyperthermia and exercise therapy were more effective in comparison to controls or placebo in the short term (moderate evidence). For the effectiveness of hyperthermia, no midterm or long-term results were studied. In the midterm, exercise therapy gave the best results (moderate evidence) compared to placebo or controls. For other interventions, conflicting, limited or no evidence was found. CONCLUSIONS: Some physiotherapeutic treatments seem to be promising (moderate evidence) to treat SIS, but more research is needed before firm conclusions can be drawn.

Br J Sports Med 2013 Nov 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24217037

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Effect of low-level laser stimulation on EEG power in normal subjects with closed eyes.

Wu JH, Chang YC

Department of Biomedical Engineering, Ming Chuan University, No. 5 Deming Road, Guishan Township, Taoyuan County 333, Taiwan.

In a previous study, we found that the low-level laser (LLL) stimulation at the palm with a frequency of 10 Hz was able to induce significant brain activation in normal subjects with opened eyes. However, the electroencephalography (EEG) changes to LLL stimulation in subjects with closed eyes have not been studied. In the present study, the laser array stimulator was applied to deliver insensible laser stimulations to the palm of the tested subjects with closed eyes (the laser group). The EEG activities before, during, and after the laser stimulation were collected. The EEG amplitude powers of each EEG frequency band at 19 locations were calculated. These power data were then analyzed by SPSS software using repeated-measure ANOVAs and appropriate posthoc tests. We found a pronounced decrease in the EEG power in alpha-bandwidth during laser simulation and then less decrease in the EEG power in delta-bandwidth in normal subjects with laser stimulation. The EEG power in beta-bandwidth in the right occipital area also decreased significantly in the laser group. We suggest that LLL stimulation might be conducive to falling into sleep in patients with sleep problems.

Evid Based Complement Alternat Med 2013 2013 476565

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24288562

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Efficacy of Low-Level Laser Therapy in the Management of Tinnitus due to Noise-Induced Hearing Loss: A Double-Blind Randomized Clinical Trial.

Mollasadeghi A, Mirmohammadi SJ, Mehrparvar AH, Davari MH, Shokouh P, Mostaghaci M, Baradaranfar MH, Bahaloo M

Department of Occupational Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, P.O. Box 89138-14389, Yazd, Iran.

Background. Several remedial modalities for the treatment of tinnitus have been proposed, but an effective standard treatment is still to be confirmed. In the present study, we aimed to evaluate the effect of low-level laser therapy on tinnitus accompanied by noise-induced hearing loss. Methods. This was a double-blind randomized clinical trial on subjects suffering from tinnitus accompanied by noise-induced hearing loss. The study intervention was 20 sessions of low-level laser therapy every other day, 20 minutes each session. Tinnitus was assessed by three methods (visual analog scale, tinnitus handicap inventory, and tinnitus loudness) at baseline, immediately and 3 months after the intervention. Results. All subjects were male workers with age range of 30-51 years. The mean tinnitus duration was 1.85 +/- 0.78 years. All three measurement methods have shown improved values after laser therapy compared with the placebo both immediately and 3 months after treatment. Laser therapy revealed a U-shaped efficacy throughout the course of follow-up. Nonresponse rate of the intervention was 57% and 70% in the two assessment time points, respectively. Conclusion. This study found low-level laser therapy to be effective in alleviating tinnitus in patients with noise-induced hearing loss, although this effect has faded after 3 months of follow-up. This trial is registered with the Australian New Zealand clinical trials registry with identifier ACTRN12612000455864).

ScientificWorldJournal 2013 2013 596076

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24288494

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Can osteoarthritis be treated with light?

Hamblin MR

Osteoarthritis is becoming more problematic as the population ages. Recent reports suggest that the benefit of anti-inflammatory drugs is unimpressive and the incidence of side effects is worrying. Low-level laser (light) therapy (LLLT) is an alternative approach with no known side effects and with reports of substantial therapeutic efficacy in osteoarthritis. In this issue of Arthritis Research & Therapy, Alves and colleagues used a rat model of osteoarthritis produced by intra-articular injection of the cartilage-degrading enzyme papain to test 810-nm LLLT. A single application of LLLT produced significant reductions in inflammatory cell infiltration and inflammatory cytokines 24 hours later. A lower laser power was more effective than a higher laser power. However, more work is necessary before the title question can be answered in the affirmative.

Arthritis Res Ther 2013 15(5) 120

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24286607

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A Controlled Trial to Determine the Efficacy of Red and Near-Infrared Light Treatment in Patient Satisfaction, Reduction of Fine Lines, Wrinkles, Skin Roughness, and Intradermal Collagen Density Increase.

Wunsch A, Matuschka K

1 Medical Light Consulting , Heidelberg, Germany .

Abstract Objective: The purpose of this study was to investigate the safety and efficacy of two novel light sources for large area and full body application, providing polychromatic, non-thermal photobiomodulation (PBM) for improving skin feeling and appearance. Background data: For non-thermal photorejuvenation, laser and LED light sources have been demonstrated to be safe and effective. However, lasers and LEDs may offer some disadvantages because of dot-shaped (punctiform) emission characteristics and their narrow spectral bandwidths. Because the action spectra for tissue regeneration and repair consist of more than one wavelength, we investigated if it is favorable to apply a polychromatic spectrum covering a broader spectral region for skin rejuvenation and repair. Materials and methods: A total of 136 volunteers participated in this prospective, randomized, and controlled study. Of these volunteers, 113 subjects randomly assigned into four treatment groups were treated twice a week with either 611-650 or 570-850 nm polychromatic light (normalized to approximately 9 J/cm2 in the range of 611-650 nm) and were compared with controls (n=23). Irradiances and treatment durations varied in all treatment groups. The data collected at baseline and after 30 sessions included blinded evaluations of clinical photography, ultrasonographic collagen density measurements, computerized digital profilometry, and an assessment of patient satisfaction. Results: The treated subjects experienced significantly improved skin complexion and skin feeling, profilometrically assessed skin roughness, and ultrasonographically measured collagen density. The blinded clinical evaluation of photographs confirmed significant improvement in the intervention groups compared with the control. Conclusions: Broadband polychromatic PBM showed no advantage over the red-light-only spectrum. However, both novel light sources that have not been previously used for PBM have demonstrated efficacy and safety for skin rejuvenation and intradermal collagen increase when compared with controls.

Photomed Laser Surg 2013 Nov 28

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24286286

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Low-dose laser acupuncture for non-specific chronic low back pain: a double-blind randomised controlled trial.

Glazov G, Yelland M, Emery J

School of Primary, Aboriginal and Rural Health Care, University of Western Australia, , Crawley, Western Australia, Australia.

OBJECTIVE: To determine if infrared laser acupuncture (LA) may have a specific effect in reducing pain and disability in treatment of chronic low back pain (LBP). METHODS: This was a double-blind sham laser controlled trial performed in general practices in Perth, Western Australia. The participants were 144 adults with chronic non-specific LBP. They were randomised to receive eight once-weekly treatments. Laser machines (20 mW, 840 nm diode, power density 0.1 W/cm2) stimulated points in three treatment groups: sham (0 joules/point), low dose (0.2 J/point) and high dose (0.8 joules/point). Participants were followed-up at 1 and 6 weeks, and 6 and 12 months post treatment. Primary outcomes were pain (Numerical Pain Rating Scale (NPRS)) and disability (Oswestry Disability Inventory (ODI)) at 6 weeks post treatment. Secondary outcomes included numerical rating scale for limitation of activity, global assessment of improvement, analgesic usage and adverse effects after treatment. RESULTS: The analysis showed no difference between sham and the laser groups at 6 weeks for pain or disability. There was a significant reduction in mean pain and disability in all groups at 6 weeks (p<0.005); NPRS: sham (-1.5 (95% CI -2.1 to -0.8)), low dose (-1.3 (-2.0 to -0.8)), high dose (-1.1 (-1.7 to -0.5)). ODI: sham (-4.0 (-7.1 to -1.0)), low dose (-4.1, (-6.7 to -1.5)), high dose (-2.6 (-5.7 to 0.5)). All secondary outcomes also showed clinical improvement over time but with no differences between groups. CONCLUSIONS: LA using energy density range (0-4 J/cm2) for the treatment of chronic non-specific LBP resulted in clinical improvement unrelated to laser stimulation. TRIAL REGISTRATION: http://www.anzctr.org.au ACTRN12610000043033.

Acupunct Med 2013 Dec 18

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24280948

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Preliminary results of pinpoint plantar long-wavelength infrared light irradiation on blood glucose, insulin and stress hormones in patients with type 2 diabetes mellitus.

Ryotokuji K, Ishimaru K, Kihara K, Namiki Y, Hozumi N

Faculty of Health Sciences, Ryotokuji University, Urayasu, Japan.

Background and aims: This study was aimed at the development of a novel noninvasive treatment system, “pinpoint plantar long-wavelength infrared light irradiation (PP-LILI)”, which may be able to relieve mental stress and normalize blood glucose level via the reduction of stress hormones in type 2 (non-insulin-dependent) diabetes mellitus (DM) patients. MATERIALS (SUBJECTS) AND METHODS: Based on this hypothesis, the present study was undertaken to examine effects of PP-LILI on stress hormones (ACTH and cortisol), blood glucose, HbA1c, and insulin levels in 10 patients with type 2 DM. Each patient received PP-LILI of the foot for 15 minutes once weekly using a stress free apparatus (infrared wavelength, 9,000-12,000 nm/power 30 mW). Results: In response to this therapy, ACTH (P<0.01) and cortisol (P<0.05) levels decreased significantly. Fasting blood glucose (P<0.05) and insulin (P<0.05) levels also decreased significantly along with a tendency for HbA1c to decrease. Conclusions: The present data raise the possibility that PP-LILI can normalize blood glucose levels by reducing stress hormones such as cortisol, which aggravate DM, and by improving insulin sensitivity, thereby contributing to prevention and treatment of DM.

Laser Ther 2013 22(3) 209-14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24204095

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Long-term effect of high-intensity laser therapy in the treatment of patients with chronic low back pain: a randomized blinded placebo-controlled trial.

Alayat MS, Atya AM, Ali MM, Shosha TM

Basic Science Department, Faculty of Physical Therapy, Cairo University, 7 Ahmed Elziat Street from Eltahrir Street, Cairo, Egypt, mohsalahpt@hotmail.com.

The aim of this study was to compare the effect of high-intensity laser therapy (HILT), alone or combined with exercise, in the treatment of chronic low back pain (CLBP). A total of 72 male patients participated in this study, with a mean (SD) age of 32.81 (4.48) years. Patients were randomly assigned into three groups and treated with HILT plus exercise (HILT + EX), placebo laser plus exercise (PL + EX), and HILT alone in groups 1, 2, and 3, respectively. The outcomes measured were lumbar range of motion (ROM), pain level by visual analog scale (VAS), and functional disability by both the Roland Disability Questionnaire (RDQ) and the Modified Oswestry Disability Questionnaire (MODQ). Statistical analyses were performed to compare the differences between baseline and post-treatment measurements. The level of statistical significance was set as P < 0.05. ROM significantly increased after 4 weeks of treatment in all groups, then significantly decreased after 12 weeks of follow-up, but was still significantly more than the baseline value in groups 1 and 2. VAS, RDQ, and MODQ results showed significant decrease post-treatment in all groups, although the RDQ and MODQ results were not significantly different between groups 2 and 3. HILT combined with exercise appears to be more effective in patients with CLBP than either HLLT alone or placebo laser with exercise.

Lasers Med Sci 2013 Nov 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24178907

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The use of infrared radiation in the treatment of skin laxity.

Felici M, Gentile P, De Angelis B, Puccio L, Puglisi A, Felici A, Delogu P, Cervelli V

San Camillo Hospital, Plastic Surgery , Rome , Italy.

Background: Cosmetic surgery and medicine are extremely interesting fields for a plastic surgeon. Lasers and lights determine ablation, contraction and regenerating stimulus in skin tissues. The aim of this study is to examine the use of infrared lights in treating facial and body skin laxity. Methods: Between 2007 and 2011, in the Department of Plastic and Reconstructive Surgery at the Hospital San Camillo-Forlanini, 303 patients were enrolled in the study and underwent laser therapy. The laser operates in wavelength from 1100 to 1800 nm. The treated areas are: face, neck, eyebrows, abdomen, legs and buttocks. Results: We have noticed no systemic complications. A case of a patient with a three days lasting erythema on both lower eyelids caused by laser therapy healed without any pharmacological therapy. Neither hyper- nor hypopigmentation of the skin was found. The satisfaction degree of patients has been: facial, neck and eyebrow lifting “very satisfactory” for 70% of the patients, “satisfactory” for 10%, “unsatisfactory” for 20%; for the other areas it was “very satisfactory” for 40%, “satisfactory” for 20% and “unsatisfactory” for 40%. Conclusion: The use of infrared radiation represents a valid alternative to surgical lifting, but cannot replace it. The infrared light technique used has turned out to be useful in contrasting skin laxity of the face and other parts of the body. The absence of scars and surgical risk makes this technique useable for a large number of patients.

J Cosmet Laser Ther 2013 Dec 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24215421

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[Efficacy observation of carpal tunnel syndrome treated with electroacupuncture].

Xia Q, Liu XW, Wang XL, Tao Y

Rehabilitation Department of TCM, First Hospital Affiliated to Dalian Medical University Dalian 116011, Liaoning Province, China.

OBJECTIVE: To explore the impacts of electroacupuncture on median nerve conduction velocity and morphology in patients of carpal tunnel syndrome (CTS) and evaluate the efficacy of electroacupuncture on CTS. METHODS: Thirty cases of CTS were treated with electroacupuncture at Quchi (LI 11), Yangchi (TE 4), Shousanli (LI 10), Neiguan (PC 6) and Hegu (LI 4) on the affected side, combined with semiconductor laser irradiation at Shenmen (HT 7) and Yangxi (LI 5) on the affected side. The improvements in the symptoms and changes in nerve conduction velocity and ultrasound morphology were observed before and after treatment. RESULT: The clinical total effective rate was 96.7% (29/30). The median nerve conduction velocity was accelerated apparently and the amplitude was increased after treatment as compared with those before treatment, indicating the statistically significant difference (all P<0.001). The distal motor latency was shortened apparently (P<0.001) and the motor amplitude had no apparent change (P>0.05). The proximal median nerve swelling was relieved apparently after treatment (P<0.05) and the effective rate was 36.7% (11/30). There was no apparent difference in the ratio of the vertical and horizontal diameters of carpal tunnel after treatment as compared with that before treatment (P>0.05). CONCLUSION: Electroacupuncture presents the positive repair function to the median nerve in the patients of CTS. It can effectively alleviate inflammatory reaction and relieve ischemia and swelling of nerve fibers. And it cannot induce the changes in morphology in a short term.

Zhongguo Zhen Jiu 2013 Aug 33(8) 700-2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24195210

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Clinical evaluation of two desensitizing treatments in southern Brazil: A 3-month follow-up.

Lund RG, Silva AF, Piva E, Da Rosa WL, Heckmann SS, Demarco FF

Department of Restorative Dentistry, Postgraduate Program in Dentistry, Faculty of Dentistry.

OBJECTIVE: This study aimed to evaluate and compare the effectiveness of two treatments for dentin hypersensitivity in vivo during 90 days of follow-up. MATERIALS AND METHODS: The sample consisted of 117 teeth (13 patients) that were divided into three groups: control with carbomer 940 gel (n = 32) (placebo treatment), 2% sodium fluoride gel (n = 31) and low-level infrared diode laser (n = 54). Prior to the desensitizing treatment, the dentin hypersensitivity status of each tooth was assessed by an evaporative stimulus; the patient’s response was evaluated using the Visual Analogue Scale (VAS) and by counting the Exposure Time to Air Blast (ETAB) with a dental air syringe. Re-evaluations of the treatments occurred after 5 min, 7, 15, 30 and 90 days. The statistical analysis was performed using the Kruskal-Wallis test, Friedman test, one-way ANOVA, Tukey’s test and Spearman’s rank correlation (alpha = 5%). RESULTS: No significant differences were observed among the low-level laser, 2% topical fluoride and carbomer 940 gel applications. When the methods of evaluation (VAS and ETAB) were compared, there was no difference among the groups with respect to the values for every period of evaluation (p < 0.001), verifying that the scores obtained with the VAS decreased at the same proportion as the remaining time of ETAB increased. CONCLUSIONS: This study showed that both tested therapies were efficacious in controlling painful symptoms associated with dentin hypersensitivity over the entire 90-day follow-up period. The treatments were able to reduce the painful symptoms caused by dentin hypersensitivity, including placebo.

Acta Odontol Scand 2013 Nov 71(6) 1469-74

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24180588

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Laser therapy takes to the superhighway of the world wide web!

Ohshiro T

Laser Ther 2013 22(3) 161

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24204088

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Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial.

Oliveira Sierra S, Melo Deana A, Agnelli Mesquita Ferrari R, Maia Albarello P, Kalil Bussadori S, Porta Santos Fernandes K

BACKGROUND: Low-level laser therapy (LLLT) has been shown to modulate the inflammatory process without adverse effects , by reducing pain and swelling and promoting the repair of damaged tissues. Because pain, swelling and muscle spasm are complications found in virtually all patients following oral surgery for the removal of impacted teeth, this model has been widely used to evaluate the effects of LLLT on the inflammatory process involving bone and, connective tissue and the muscles involved in mastication. The aim of the present study was to evaluate the effectiveness of LLLT in reducing pain, swelling and muscle spasm resulting from the removal of impacted lower third molars and evaluate the effects of surgery on patients’ quality of life of patients (QOL).Methods/design: After meeting the eligibility criteria, 60 patients treated at a Specialty Dental Center for the removal of impacted lower third molars will be randomly divided into five groups according to the type of laser therapy used at the end of surgery (intraoral irradiation with 660 nm laser; extraoral irradiation with 660 nm laser; intraoral irradiation with 808 nm laser; extraoral irradiation with 808 nm laser and no irradiation). To ensure that patients are blinded to the type of treatment they are receiving, the hand piece of the laser apparatus will be applied both intraorally and extraorally to all participants, but the device will be turned on only at the appropriate time, as determined by the randomization process. At 2 and 7 days after surgery, the patients will be evaluated by three blinded evaluators who will measure of swelling, mouth opening (muscle spasm evaluation) and pain (using two different pain scales). The 14-item Oral Health Impact Profile (OHIP-14) will be used to assess QOL. All data will be analyzed with respect to the normality of distribution using the Shapiro-Wilk test. Statistically significant differences between the experimental groups will be determined using analysis of variance, followed by a suitable post hoc test, when necessary. The significance level will be set at alpha = 0.05. DISCUSSION: The lack of standardization in studies with regard to the samples, methods and LLLT parameters complicates the determination of the actual effect of laser therapy on this model. The present study aims to provide a randomized, controlled, double-blind trial to compare four different LLLT parameters in relation to the outcomes of pain, swelling and muscle spasm following surgery for the extraction of impacted third molars.Trial registration: Brazilian Registry of Clinical Trials – Rebec (RBR-6XSB5H).

Trials 2013 Nov 6 14(1) 373

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24195796

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Role of nitric oxide in responses of pial arterial vessels to low-intensity red laser irradiation.

Gorshkova OP, Shuvaeva VN, Dvoretsky DP

I. P. Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia. vshuv@kolt.infran.ru.

The responses of rat pial vessels to red laser irradiation can be mediated by NO. NO mainly affects major arteries and did not contribute to reactivity of small pial arteries and precortical arterioles.

Bull Exp Biol Med 2013 Aug 155(5) 598-600

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24288717

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High-intensity Nd:YAG laser accelerates bone regeneration in calvarial defect models.

Kim K, Kim IS, Cho TH, Seo YK, Hwang SJ

New York Seoul Dental Hospital, Seoul, Republic of Korea.

High-power pulsed lasers have been recently regarded to be anabolic to bone, but in vivo evidence is still lacking. This study aimed to investigate the capacity of bone repair using a high-power, Q-switched, pulsed, neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, using bilateral calvarial defect models having non-critical sized, 5 mm (rat) or 8 mm (rabbit) diameter. One of the bilateral defects, which were all filled with collagen sponge or left empty, was irradiated with a Nd:YAG laser once every 2 days for 2 weeks at a constant total fluence rate (344 J/cm2 ), output power (0.75 W), pulse repetition rate (15 pps) and wavelength (1064 nm) and examined for the laser effect. The same experimental scheme was designed using a rabbit calvarial defect model implanted with sponge, which was explored for the dose effect of output power at 0.75 and 3 W with the same quantities of the other parameters. New bone formation was evaluated by micro-computed tomography-based analysis and histological observation at 4 weeks after surgery. Laser irradiation significantly increased new bone formation by approximately 45%, not only in the sponge-filled defects of rats but also when the defects were left empty, compared to the non-irradiated group. Consistently, both doses of output power (0.75 and 3 W) enhanced new bone formation, but there was no significant difference between the two doses. This study is one of the first to demonstrate the beneficial effect of Nd:YAG lasers on the regeneration of bone defects which were left empty or filled with collagen sponge, suggesting its great potential in postoperative treatment targeting local bone healing. Copyright (c) 2013 John Wiley & Sons, Ltd.

J Tissue Eng Regen Med 2013 Nov 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24254743

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Effect of near-infrared light exposure on mitochondrial signaling in CC muscle cells.

Nguyen LM, Malamo AG, Larkin-Kaiser KA, Borsa PA, Adhihetty PJ

Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, United States. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, United States. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, United States. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, United States. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, United States. Electronic address: padhihetty@hhp.ufl.edu.

Near-infrared (NIR) light is a complementary therapy used to treat musculoskeletal injuries but the underlying mechanisms are unclear. Acute NIR light treatment (~800-950nm; 22.8J/cm2) induced a dose-dependent increase in mitochondrial signaling (AMPK, p38 MAPK) in differentiated muscle cells. Repeated NIR light exposure (4days) appeared to elevate oxidative stress and increase the upstream mitochondrial regulatory proteins AMPK (3.1-fold), p38 (2.8-fold), PGC-1alpha (19.7%), Sirt1 (26.8%), and reduced RIP140 (23.2%), but downstream mitochondrial regulation/content (Tfam, NRF-1, Sirt3, cytochrome c, ETC subunits) was unaltered. Our data indicates that NIR light alters mitochondrial biogenesis signaling and may represent a mechanistic link to the clinical benefits.

Mitochondrion 2013 Nov 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24246911

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Layer-specific modulation of neuronal excitability by 660-nm laser irradiation in mouse neocortex.

Kumazaki K, Mieda T, Kogure S, Kawai H

Department of Bioinformatics, Graduate School of Engineering, Soka University, 1-236 Tangi-machi, Hachioji, Tokyo, 192-8577, Japan.

It has been reported that laser light irradiation (LLI) could regulate neuronal activities in the forebrain, but little is known if and how LLI in the red wavelength range affects neuronal excitability. Here, we investigated the effects of a continuous diode laser at 660 nm on intrinsic membrane properties and excitability of presumed pyramidal neurons in the thalamocortical input layer (layer 3/4) and in layer 5 of mouse primary auditory cortex using the whole-cell patch-clamp recording technique. In layer 3/4 neurons, 660-nm laser irradiation (LLI-660) at 20 mW for 5 min gradually increased resting membrane potentials, which reached a plateau after irradiation. Concomitantly, LLI-660 decreased onset latency of first action potentials (spikes) without changing spike threshold or peak amplitude, but increased inter-spike interval of initial bursting spike doublets and their peak amplitude ratio. None of these changes was observed in layer 5 neurons. Instead, LLI-660 at 20 mW rapidly reduced spike width ~5 % within 1 min of irradiation onset. The magnitude of this reduction did not change during 5 or 10 min irradiation, and returned quickly to at least baseline levels after turning the LLI off. Decreasing laser power to 10 mW reduced spike width to a lesser extent, suggesting laser power dependence of this phenomenon. These data suggest that LLI-660 regulates different aspects of neuronal excitability in cortical neurons in a layer-dependent manner possibly by affecting different voltage-gated ion channels.

Lasers Med Sci 2013 Nov 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24232863

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Regulation of Na /K -ATPase by neuron-specific transcription factor Sp4: implication in the tight coupling of energy production, neuronal activity and energy consumption in neurons.

Johar K, Priya A, Wong-Riley MT

Department of Cell Biology, Neurobiology, and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.

A major source of energy demand in neurons is the Na+ /K+ -ATPase pump that restores the ionic gradient across the plasma membrane subsequent to depolarizing neuronal activity. The energy comes primarily from mitochondrial oxidative metabolism, of which cytochrome c oxidase (COX) is a key enzyme. Recently, we found that all 13 subunits of COX are regulated by specificity (Sp) factors, and that the neuron-specific Sp4, but not Sp1 or Sp3, regulates the expression of key glutamatergic receptor subunits as well. The present study sought to test our hypothesis that Sp4 also regulates Na+ /K+ -ATPase subunit genes in neurons. By means of multiple approaches, including in silico analysis, electrophoretic mobility shift and supershift assays, chromatin immunoprecipitation, promoter mutational analysis, over-expression, and RNA interference studies, we found that Sp4, with minor contributions from Sp1 and Sp3, functionally regulate the Atp1a1, Atp1a3, and Atp1b1 subunit genes of Na+ /K+ -ATPase in neurons. Transcripts of all three genes were up-regulated by depolarizing KCl stimulation and down-regulated by the impulse blocker tetrodotoxin (TTX), indicating that their expression was activity-dependent. Silencing of Sp4 blocked the up-regulation of these genes induced by KCl, whereas over-expression of Sp4 rescued them from TTX-induced suppression. The effect of silencing or over-expressing Sp4 on primary neurons was much greater than those of Sp1 or Sp3. The binding sites of Sp factors on these genes are conserved among mice, rats and humans. Thus, Sp4 plays an important role in the transcriptional coupling of energy generation and energy consumption in neurons.

Eur J Neurosci 2013 Nov 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24219545

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Nanoparticle-emitted light attenuates amyloid-beta-induced superoxide and inflammation in astrocytes.

Bungart BL, Dong L, Sobek D, Sun GY, Yao G, Lee JC

Department of Biological Engineering, University of Missouri, Columbia, MO.

Alzheimer’s disease (AD) is the sixth leading cause of age-related death with no effective intervention yet available. Our previous studies have demonstrated the potential efficacy of Low Level Laser Therapy (LLLT) in AD cell models by mitigating amyloid-beta peptide (Abeta)-induced oxidative stress and inflammation. However, the penetration depth of light is still the major challenge for implementing LLLT in animal models and in the clinical settings. In this study, we present the potential of applying Bioluminescence Resonance Energy Transfer to Quantum Dots (BRET-Qdots) as an alternative near infrared (NIR) light source for LLLT. Our results show that BRET-Qdot-emitted NIR suppresses Abeta-induced oxidative stress and inflammatory responses in primary rat astrocytes. These data provide a proof of concept for a nanomedicine platform for LLLT.

Nanomedicine 2013 Nov 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24200521

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Phototherapy with artificial light suppresses dextran sulfate sodium-induced colitis in a mouse model.

Hiratsuka T, Inomata M, Goto S, Oyama Y, Nakano T, Chen CL, Shiraishi N, Noguchi T, Kitano S

Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.

BACKGROUND AND AIM: Medical treatment for inflammatory bowel disease (IBD) requires chronic administration and causes side effects. Recently, anti-inflammatory effects of phototherapy were reported in animal models. The present study evaluated whether phototherapy improves dextran sulfate sodium (DSS)-induced colitis in a mouse model of IBD. METHODS: Mice were divided into four equal groups: Control, DSS, DSS + light low (LL), and DSS + light high (LH) groups. Normal fluorescent light intensity in the Control and DSS groups was 200 lux. Artificial light intensities were as follows: DSS + LL group, 1000 lux; DSS + LH group, 2500 lux. After administering phototherapy for 7 days, we evaluated disease activity index (DAI), histological score, colon length/weight, serum 1,25-dihydroxyvitamin D(3) level, and serum and colonic cytokines in the mice. RESULTS: DAI and histological scores were significantly lower in the DSS + LL group than in the DSS group (both, P <0.05). Colon length and weight were significantly higher in the DSS + LL group than in the DSS group (both, P <0.05). Serum interleukin (IL)-6, TNF-alpha, and IL-17 in the DSS + LL group were significantly lower and serum and colonic IL-10 were significantly higher in the DSS + LL group than in the DSS group (all, P <0.05). Serum 1,25-dihydroxyvitamin D(3) levels in the DSS + LH group were significantly increased compared with those in the DSS + LL and DSS groups. CONCLUSIONS: Artificial light phototherapy suppressed DSS-induced colitis in mice by suppression of pro-inflammatory cytokines and promotion of anti-inflammatory cytokines.

J Gastroenterol Hepatol 2013 Nov 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24236761

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Evaluation of anti-nociceptive and anti-inflammatory activity of low-level laser therapy on temporomandibular joint inflammation in rodents.

Barretto SR, de Melo GC, Dos Santos JC, de Oliveira MG, Pereira-Filho RN, Alves AV, Ribeiro MA, Lima-Verde IB, Quintans Junior LJ, de Albuquerque-Junior RL, Bonjardim LR

Tiradentes University, Av. Murilo Dantas, 300, Farolandia, CEP 49030-490, Aracaju/SE, Brazil. Electronic address: nanaestetica@yahoo.com.br.

The aim of this study was to investigate the analgesic and anti-inflammatory activity of low-level laser therapy (LLLT) on the nociceptive behavioral as well as histomorphological aspects induced by injection of formalin and carrageenan into the rat temporomandibular joint. The 2.5% formalin injection (FRG group) induced behavioral responses characterized by rubbing the orofacial region and flinching the head quickly, which were quantified for 45min. The pretreatment with systemic administration of diclofenac sodium-DFN group (10mg/kg i.p.) as well as the irradiation with LLLT infrared (LST group, 780nm, 70mW, 30s, 2.1J, 52.5J/cm(2), GaAlAs) significantly reduced the formalin-induced nociceptive responses. The 1% carrageenan injection (CRG group) induced inflammatory responses over the time-course of the study (24h, and 3 and 7days) characterized by the presence of intense inflammatory infiltrate rich in neutrophils, scanty areas of liquefactive necrosis and intense interstitial edema, extensive hemorrhagic areas, and enlargement of the joint space on the region. The DFN and LST groups showed an intensity of inflammatory response that was significantly lower than in CRG group over the time-course of the study, especially in the LST group, which showed exuberant granulation tissue with intense vascularization, and deposition of newly formed collagen fibers (3 and 7days). It was concluded that the LLLT presented an anti-nociceptive and anti-inflammatory response on the inflammation induced in the temporomandibular joint of rodents.

J Photochem Photobiol B 2013 Dec 5 129 135-42

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24231378

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The effect of low-level laser irradiation on muscle tension and hardness compared among three wavelengths.

Yonezu T, Kogure S

Graduate School of Sports Science, Waseda University, Japan.

Background and Aims: It has been reported that low-level laser irradiation (LLLI) can influence muscle tissue by retarding attenuation of muscle tension. Since the efficacy of LLLI on the effects of muscle contraction remains unclear, we examined in an in vivo animal model whether LLLI affects both muscle tension and muscle hardness in a wavelength-dependent manner, using the rat gastrocnemius muscle. Material and Methods: Forty Sprague-Dawley adult rats were used. Under pentobarbital sodium anesthesia, their gastrocnemius muscle and tibial nerve were exteriorized. Diode LLLI systems delivering 3 wavelengths (405, 532, and 808 nm; 100 mW output) were used. Ten sets of tetanus (tetanic contractions) were delivered to the tibial nerve followed by a brief rest or LLLI for 15 s and an additional 7 sets of tetanus with an inter-stimulus interval of 5 min. The muscle tension and muscle hardness were measured with a tension transducer and hardness meter, respectively. Results: 405 nm LLLI did not influence either muscle tension or hardness. 532 nm LLLI significantly improved the maintenance of muscle tension compared with the 808 nm group (P<0.05). In contrast, 808 nm LLLI significantly improved the recovery from muscle hardness compared with the other groups (P<0.05). Conclusion: We conclude that LLLI has wavelength-dependent effects on the gastrocnemius muscle and LLLI at appropriate wavelengths and dosimetry offers potential in the treatment to relieve muscle tension or stiffness.

Laser Ther 2013 22(3) 201-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24204094

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Analysis of the effect of phototherapy in model with traumatic Achilles tendon injury in rats.

Casalechi HL, de Farias Marques AC, da Silva EA, Aimbire F, Marcos RL, Lopes-Martins RA, de Carvalho PD, Albertini R

Post Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Rua Vergueiro, 235, Sao Paulo, SP, 01504-001, Brazil.

The aim of this study was to investigate the effect of low-intensity laser (LILT) infrared (830 nm) therapy in tendon inflammation, tendinitis induced by mechanical trauma in rat Achilles tendon. For this, we used 65 young male Wistar rats, weighing +/-300 g divided into different groups: C = control (n = 5) and experimental (n = 10/group), with two different times of sacrifice such as treated with L = laser, D = treated with diclofenac, and T = untreated injured. The tendon inflammation was induced by controlled contusion in the medial region of the Achilles tendon of the animals. The treated groups received some kind of intervention every 24 h, all groups were sacrificed on the 7th or 14th day after the trauma. The tendons were dissected, extracted, and sent for analysis. Histological analysis of the L group showed a decrease in the number of inflammatory cells in relation to other groups in both periods studied. The comparative results between the number of inflammatory cells in the control and treated groups at 7 and 14 days showed statistically significant differences. Qualitative analysis findings obtained by the picrosirius red technique under polarized light showed that in 7 days, the T group presented collagen types I and III in the same proportion; group D presented a predominance of type III fibers, while in group L, type I collagen predominated. The 14-day group D showed collagen types I and III in the same proportion, while in group L, there was a predominance of type I fibers. Biomechanical analysis showed that 7-day groups L and C showed similar stiffness and increased breaking strength. The 14-day groups L and C showed greater rupturing strength as well as increased stiffness angle. Group D showed a decrease of maximum traction strength and degree of rigidity. It was concluded that treatment with LIL in the parameters used and the times studied reduces migration of inflammatory cells and improves the quality of repair while reducing the functional limitations.

Lasers Med Sci 2013 Nov 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24186775

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Comparative analysis of two low-level laser doses on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation.

Dos Santos SA, Alves AC, Leal-Junior EC, Albertini R, Vieira RD, Ligeiro AP, Junior JA, de Carvalho PD

Department of Physical Therapy, Universidade Nove de Julho (UNINOVE), Sao Paulo, Sao Paulo, Brazil.

Synovial membrane inflammation plays an important role in osteoarthritis (OA) pathophysiology. The synovial tissue of patients with initial OA is characterized by mononuclear cell infiltration and the production of pro-inflammatory cytokines and other mediators of joint injury. The study aims to evaluate the effect of low-level laser therapy (LLLT) at doses of 2 and 4 J on joint inflammation in rats induced by papain through histopathological analysis, differential counts of inflammatory cells; gene expression of IL-1beta, IL-6, and IL-10; and TNF-alpha protein expression. Male Wistar rats (20) were randomly divided (5 animals each) into a negative control group, an inflammation injury positive control group, a 2-J LLLT group subjected to injury and treated with 2 J of LLLT, and a 4-J LLLT group subjected to injury and treated with 4 J of LLLT. The animals were subjected to joint inflammation (4 % papain solution) and treated with LLLT. On the day of euthanasia, articular lavage was collected and centrifuged. The supernatant was analyzed for TNF-alpha protein expression by ELISA and IL-1beta, IL-6, and IL-10 mRNA by RT-PCR. The joint tissue was also examined histologically. ANOVA with Tukey’s post hoc test was used for comparisons. All data were expressed as means +/- S.D. (p < 0.05). Both laser modalities were efficient in reducing cellular inflammation and decreasing the expression of IL-1beta and IL-6. However, the 2-J treatment led to more reduction in TNF-alpha than the 4-J treatment. A single application of LLLT with 2 J was more efficient in modulating inflammatory mediators and inflammatory cells.

Lasers Med Sci 2013 Oct 31

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24173911

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Effects of laser and ozone therapies on bone healing in the calvarial defects.

Kazancioglu HO, Ezirganli S, Aydin MS

From the *Department of Oral and Maxillofacial Surgery, Faculty of Dentistry; and daggerDepartment of Histology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

This study aims to analyze the effect of the low-level laser therapy (LLLT) and ozone therapy on the bone healing of critical size defect (CSD) in rat calvaria. A total of 30 Wistar male rats were used. A 5-mm-diameter trephine bur was used to create CSD on the right side of the parietal bone of each rat calvarium. Once the bone was excised, a synthetic biphasic calcium phosphate graft material was implanted to all the bone defect sites. The animals were randomly divided into 3 groups as follows: the control group (n = 10), which received no LLLT or ozone therapy; the LLLT group (n = 10), which received only LLLT (120 seconds, 3 times a week for 2 weeks); and the ozone therapy group (n = 10) (120 seconds, 3 times a week for 2 weeks). After 1 month, all the rats were killed, and the sections were examined to evaluate the presence of inflammatory infiltrate, connective tissue, and new bone formation areas. Histomorphometric analyses showed that in the LLLT and ozone groups, the new bone areas were significantly higher than in the control group (P < 0.05). In the LLLT group, higher new bone areas were found than in the ozone group (P < 0.05). This study demonstrated that both ozone and laser therapies had a positive effect on bone formation in rat calvarial defect, compared with the control group; however, ozone therapy was more effective than LLLT (808 nm; 0.1 W; 4 J/cm(2); 0.028 cm(2), continuous wave mode).

J Craniofac Surg 2013 Nov 24(6) 2141-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24220424

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Microfluidic approach for direct and uniform laser irradiation to study biochemical state changes on Jurkat-T cells.

Butler SJ, Lee DW, Burney CW, Wigle JC, Choi TY

University of North Texas, Department of Physics, 1155 Union Circle, #311427, Denton, Texas 76203.

We investigated the potential for using polydimethylsiloxane microfluidic devices in a biological assay to explore the cellular stress response (CSR) associated with hyperthermia induced by exposure to laser radiation. In vitro studies of laser-tissue interaction traditionally involved exposing a monolayer of cells. Given the heating-cooling dynamics of the cells and nutrient medium, this technique produces a characteristic “bulls-eye” temperature history that plagues downstream molecular analyses due to the nonuniform thermal experience of exposed cells. To circumvent this issue, we devised an approach to deliver single cells to the laser beam using a microfluidic channel, allowing homogeneous irradiation and collection of sufficient like-treated cells to measure changes in CSR after laser heating. To test this approach, we irradiated Jurkat-T cells with a 2-mum-wavelength laser in one branch of a 100-mum-wide bifurcated channel while unexposed control cells were simultaneously passing through the other, identical channel. Cell viability was measured using vital dyes, and expression of HSPA1A was measured using reverse transcription polymerase chain reaction. The laser damage threshold was 25 +/- 2 J/cm2, and we found a twofold increase in expression at that exposure. This approach may be employed to examine transcriptome-wide/proteome changes and further comparative work across stressors and cell types.

J Biomed Opt 2013 Nov 1 18(11) 117004

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24196406

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Effect of low-level laser therapy (lambda660 nm) on angiogenesis in wound healing: a immunohistochemical study in a rodent model.

Colombo F, Neto Ade A, Sousa AP, Marchionni AM, Pinheiro AL, Reis SR

The aim of the present investigation was to evaluate the angiogenesis on dorsal cutaneous wounds in a rodent model treated with lambda660 nm laser light. New vessel formation is a multistep process involving vessel sprouting, endothelial cell migration, proliferation and tube formation. Although several in vivo studies have shown that laser phototherapy influences tissue repair, a fully understanding of angiogenesis mechanisms are not yet known. Twenty-four young adult male Wistar rats weighing between 200 and 250 g were used. Under general anesthesia, one excisional wound was created on the dorsum of each animal and they were randomly distributed into two groups: one control and one treated with laser (lambda660 nm, 16 mW, 10 J/cm2). Each group was subdivided into three subgroups according to the animal death timing (2, 4 and 6 days). Laser irradiation started immediately after surgery and was repeated every other day during the experiment and marked with Sirius Red, specific for collagen, and immunomarked with anti-TGF-beta and anti-von Willebrand factor. Marked sections underwent histological analysis by light microscopy and the mean area of the wound of each animal was calculated and analyzed by ANOVA and Tukey’s test (alpha=0.05). Although at some death periods, collagen expression and number of blood vessels on irradiated animals were higher than in the control ones, no significant differences were found at any time in relation to TGF-beta expression (p>0.05). It was concluded that laser treatment (lambda660 nm) contributed to increase angiogenesis.

Braz Dent J 2013 24(4) 308-12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24173246

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Infrared LED irradiation photobiomodulation of oxidative stress in human dental pulp cells.

Montoro LA, Turrioni AP, Basso FG, de Souza Costa CA, Hebling J

Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University Estadual Paulista (UNESP), Araraquara, SP, Brazil.

AIM: To investigate the effect of infrared light-emitting diode (LED) irradiation on the oxidative stress induced in human dental pulp cells (HDPCs) by lipopolysaccharide (LPS). METHODOLOGY: Human dental pulp cells (HDPCs) were harvested from sound primary teeth that were near exfoliation. Cells were seeded (105 cells cm-2 ) using alpha-MEM supplemented with 10% FBS and after 24 h, were placed in contact with LPS (10 mug mL-1 of culture medium). Immediately afterwards, HDPCs were subjected to a single irradiation with an infrared LED (855 nm) delivering different doses of energy (0, 2, 4, 8, 15 or 30 J cm-2 ). For each dose, there was a control group without LPS application. Twenty-four hours after irradiation, groups were tested for nitric oxide (NO) quantification, cell viability (MTT assay) and qualitative assessment of reactive oxygen species (ROS). Data were submitted to Kruskal-Wallis and Mann-Whitney tests (alpha = 0.05). RESULTS: Lipopolysaccharide (LPS)-induced stress resulted in significant increase in NO production by HDPC without causing damage to cell respiratory metabolism. Irrespective of energy dose delivered, NO production was significantly reduced when LPS-stressed cells were irradiated with infrared LED (2 J cm-2 , P = 0.003; 95% CI = 5.84-27.71; 4 J cm-2 , P = 0.001; 95% CI = 7.52-26.39; 8 J cm-2 , P = 0.0195; 95% CI = -2.86-16.01; 15 J cm-2 , P = 0.0001; 95% CI = 12.10-30.96; 30 J cm-2 , P = 0.007; 95% CI = 5.84-24.71). The highest decrease in NO production was observed when 15 J cm-2 was delivered to cells. Infrared LED irradiation resulted in a decrease in ROS production, whilst HDPC metabolism was not significantly affected. CONCLUSION: Biomodulation of oxidative stress of HPDC can be achieved by irradiation with a single dose of infrared LED. Within the range investigated, 15 J cm-2 resulted in the least production of NO.

Int Endod J 2013 Nov 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24215116

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Irradiation with a low-level diode laser induces the developmental endothelial locus-1 gene and reduces proinflammatory cytokines in epithelial cells.

Fujimura T, Mitani A, Fukuda M, Mogi M, Osawa K, Takahashi S, Aino M, Iwamura Y, Miyajima S, Yamamoto H, Noguchi T

Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, 464-8651, Nagoya, Aichi, Japan.

We demonstrated previously that low-level diode laser irradiation with an indocyanine green-loaded nanosphere coated with chitosan (ICG-Nano/c) had an antimicrobial effect, and thus could be used for periodontal antimicrobial photodynamic therapy (aPDT). Since little is known about the effects of aPDT on periodontal tissue, we here investigated the effect of low-level laser irradiation, with and without ICG-Nano/c, on cultured epithelial cells. Human oral epithelial cells were irradiated in a repeated pulse mode (duty cycle, 10 %; pulse width, 100 ms; peak power output, 5 W). The expression of the developmental endothelial locus 1 (Del-1), interleukin-6 (IL-6), IL-8, and the intercellular adhesion molecule-1 (ICAM-1) were evaluated in Ca9-22 cells stimulated by laser irradiation and Escherichia coli-derived lipopolysaccharide (LPS). A wound healing assay was carried out on SCC-25 cells irradiated by diode laser with or without ICG-Nano/c. The mRNA expression of Del-1, which is known to have anti-inflammatory activity, was significantly upregulated by laser irradiation (p < 0.01). Concurrently, LPS-induced IL-6 and IL-8 expression was significantly suppressed in the LPS + laser group (p < 0.01). ICAM-1 expression was significantly higher in the LPS + laser group than in the LPS only or control groups. Finally, compared with the control, the migration of epithelial cells was significantly increased by diode laser irradiation with or without ICG-Nano/c. These results suggest that, in addition to its antimicrobial effect, low-level diode laser irradiation, with or without ICG-Nano/c, can suppress excessive inflammatory responses via a mechanism involving Del-1, and assists in wound healing.

Lasers Med Sci 2013 Oct 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24197516

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Re-stability of dental implants following treatment of peri-implantitis.

Javed F, Hussain HA, Romanos GE

It is hypothesized that active treatment of peri-implantitis (PI) leads to re-stabilization of dental implants. The aim was to assess whether or not dental implants can re-stabilize following treatment of PI. To address the focused question, MEDLINE/PubMed and Google-Scholar databases were explored from 1977 up to and including August 2013. Any disagreements between the authors were resolved via discussion. Articles published only in English were included. Hand searching was also performed. Thirteen experimental studies were included. The treatment regimes adopted in these studies comprised of antibiotic therapy, guided bone regeneration (GBR), laser therapy, use of bone matrix proteins with membrane, conventional flap surgery and mechanical debridement. In four studies, GBR promoted new bone formation; whereas two studies showed photosensitization therapy (in combination with either mechanical debridement or GBR) to regenerate bone around peri-implant defects. Six studies reported that mechanical debridement in conjunction with antibiotic therapy promoted re-stability of dental implants. In one study, recombinant human bone matrix protein-2 with a collagen membrane helped promote re-stabilization of dental implants. New bone formation may occur to some extent around dental implants following treatment for PI; however, a “complete” re-stability may be difficult to achieve without GBR.

Interv Med Appl Sci 2013 Sep 5(3) 116-21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24265901

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Reply to comments on: “Efficacy of low-level laser therapy in the management of orthodontic pain: a systematic review and meta-analysis”

He W, Li C, Zou S

Department of Orthodontics, Guangdong Provincial Stomatological Hospital, the Affiliated Stomatological Hospital of Southern Medical University, Guangdong Provincial Stomatological Hospital, Guangzhou, China.

Lasers Med Sci 2013 Nov 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24232862

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[Use of laser for the prevention and treatment of oral mucositis induced by radiotherapy and chemotherapy of head and neck cancer.]

Munoz-Corcuera M, Gonzalez-Nieto A, Lopez-Pintor Munoz RM

Departamento de Medicina y Cirugia Bucofacial, Facultad de Odontologia, Universidad Complutense de Madrid, Madrid, Espana. Electronic address: martamcorcuera@gmail.com.

One of the complications of radiotherapy and chemotherapy is oral mucositis. Since the low energy laser is one of the most frequently recommended interventions by authors and international societies, the aim of this study is to review the scientific evidence on the use of lasers as a preventive and therapeutic in oral mucositis associated with treatment of cancer. We performed a literature search in PubMed and The Cochrane Collaboration Library, limiting the search to the last 20 years. We finally included 29 articles that contained 30 studies. Low energy laser phototherapy seems a promising intervention in both the prevention and treatment of oral mucositis associated with cancer treatment. Virtually all studies reviewed showed good results with no adverse effects and reductions in both incidence and severity of mucositis in all types of cancer treatments.

Med Clin (Barc) 2013 Nov 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24216016

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Topical Antimicrobials for Burn Infections – an Update.

Sevgi M, Toklu A, Vecchio D, Hamblin MR

BAR414, 40 Blossom Street, Boston MA,USA 02114. Hamblin@helix.mgh.harvard.edu.

The relentless rise in antibiotic resistance among pathogenic bacteria and fungi, coupled with the high susceptibility of burn wounds to infection, and the difficulty of systemically administered antibiotics to reach damaged tissue, taken together have made the development of novel topical antimicrobials for burn infections a fertile area of innovation for researchers and companies. We previously covered the existing patent literature in this area in 2010, but the notable progress made since then, has highlighted the need for an update to bring the reader up to date on recent developments. New patents in the areas of topically applied antibiotics and agents that can potentiate the action of existing antibiotics may extend their useful lifetime. Developments have also been made in biofilm-disrupting agents. Antimicrobial peptides are nature’s way for many life forms to defend themselves against attack by pathogens. Silver has long been known to be a highly active antimicrobial but new inorganic metal derivatives based on bismuth, copper and gallium have emerged. Halogens such as chlorine and iodine can be delivered by novel technologies. A variety of topically applied antimicrobials include chitosan preparations, usnic acid, ceragenins and XF porphyrins. Natural product derived antimicrobials such as tannins and essential oils have also been studied. Novel techniques to deliver reactive oxygen species and nitric oxide in situ have been developed. Light-mediated techniques include photodynamic therapy, ultraviolet irradiation, blue light, low-level laser therapy and titania photocatalysis. Passive immunotherapy employs antibodies against pathogens and their virulence factors. Finally an interesting new area uses therapeutic microorganisms such as phages, probiotic bacteria and protozoa to combat infections.

Recent Pat Antiinfect Drug Discov 2013 Nov 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24215506

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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