LLLT / Cold Laser Literature watch for April 2011

A bumper edition of 36 papers this month with some very interesting reading. At long last Roberta Chow (with a star studded cast of co-authors)  have published a systematic review of the inhibitory effects of LLLT on peripheral nerves and relevance to analgesia.  There is an RCT showing that LLLT is better than chiropractic manipulation for cervical facet dysfunction, but joint manipulation + laser is best, a study on pain during dental tooth-cavity preparation on children, three papers on oral mucositis and two on wound healing.

Inhibitory Effects of Laser Irradiation on Peripheral Mammalian Nerves and Relevance to Analgesic Effects: A Systematic Review.

Chow R, Armati P, Laakso EL, Bjordal JM, Baxter GD

1 Nerve Research Foundation, Brain and Mind Research Institute, The University of Sydney , Camperdown, New South Wales, Australia .

Abstract Objective: The objective of this review was to systematically identify experimental studies of non-ablative laser irradiation (LI) on peripheral nerve morphology, physiology, and function. The findings were then evaluated with special reference to the neurophysiology of pain and implications for the analgesic effects of low-level laser therapy (LLLT). Background: LLLT is used in the treatment of pain, and laser-induced neural inhibition has been proposed as a mechanism. To date, no study has systematically evaluated the effects of LI on peripheral nerve, other than those related to nerve repair, despite the fact that experimental studies of LI on nerves have been conducted over the past 25 years. Methods: We searched computerized databases and reference lists for studies of LI effects on animal and human nerves using a priori inclusion and exclusion criteria. Results: We identified 44 studies suitable for inclusion. In 13 of 18 human studies, pulsed or continuous wave visible and continuous wave infrared (IR) LI slowed conduction velocity (CV) and/or reduced the amplitude of compound action potentials (CAPs). In 26 animal experiments, IR LI suppressed electrically and noxiously evoked action potentials including pro-inflammatory mediators. Disruption of microtubule arrays and fast axonal flow may underpin neural inhibition. Conclusions: This review has identified a range of laser-induced inhibitory effects in diverse peripheral nerve models, which may reduce acute pain by direct inhibition of peripheral nociceptors. In chronic pain, spinal cord changes induced by LI may result in long-term depression of pain. Incomplete reporting of parameters limited aggregation of data.

Photomed Laser Surg 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21456946

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Chiropractic manipulative therapy and low-level laser therapy in the management of cervical facet dysfunction: a randomized controlled study.

Saayman L, Hay C, Abrahamse H

Chiropractor, Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, South Africa.

PURPOSE: The aim of this study was to determine the short-term effect of chiropractic joint manipulation therapy (CMT) and low-level laser therapy (LLLT) on pain and range of motion in the management of cervical facet dysfunction. METHODS: Sixty ambulatory women between the ages of 18 and 40 years with cervical facet joint pain of more than 30-day duration and normal neurologic examination were randomized to receive 1 of 3 treatment options: (1) CMT of the cervical spine, (2) LLLT applied to the cervical facet joints, or (3) a combination of CMT and LLLT. Each participant received 6 treatments in 3 weeks. The main outcome measures were as follows: the Numerical Pain Rating Scale, Neck Disability Index, Cervical Range of Motion Instrument, and Baseline Digital Inclinometer. Measurements were taken during weeks 1 (baseline), 2, 3, and 4. RESULTS: No differences existed between the 3 groups at baseline. A significant difference was seen between groups 1 (CMT) and 2 (LLLT) for cervical flexion, between groups 1 (CMT) and 3 (CMT + LLLT) for cervical flexion and rotation, and between groups 2 (LLLT) and 3 (CMT + LLLT) for pain disability in everyday life, lateral flexion, and rotation. CONCLUSION: All 3 groups showed improvement in the primary and secondary outcomes. A combination of CMT and LLLT was more effective than either of the 2 on their own. Both therapies are indicated as potentially beneficial treatments for cervical facet dysfunction. Further studies are needed to explore optimal treatment procedures for CMT and LLLT and the possible mechanism of interaction between therapies.

J Manipulative Physiol Ther 2011 Mar-Apr 34(3) 153-63

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21492750

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The effect of low level laser therapy on pain during dental tooth-cavity preparation in children.

Tanboga I, Eren F, Altinok B, Peker S, Ertugral F

Dr I. Tanboga, Marmara Universitesi Dis Hekimligi Fak. Pedodonti AD, Buyukciftlik sok. No:6 Kat:4, Nisantasi, Sisli/Istanbul 34365, Turkey. Email: itanboga@marmara.edu.tr.

AIM: To evaluate the effect of low level laser therapy on pain during cavity preparation with laser in paediatric dental patients. STUDY DESIGN AND METHODS: The study was carried out on 10 children aged 6 to 9 years old for a total of 20 primary molar teeth. For laser preparation an Er: YAG laser was used. Half of the preparations were treated by low level laser therapy (LLLT) before laser preparation and the remaining half without LLLT (non-LLLT) before laser preparation. All cavities were prepared by ER:YAG laser, restored with light-cured composite resin following the application of acid etching and bonding agent. Children were instructed to rate their pain on the visual analogue scale (VAS) from 0 to 5 points. Statistical analyses were performed using Mann Whitney U test. RESULTS: VAS Median (min-max) scores were 1(0-2) for LLLT and 3(1-4) for the non-LLT treated children. Between LLLT and non- LLLT groups results were statistically significant (p<0.01). CONCLUSIONS: The use of LLLT before cavity preparation with laser decreased pain in paediatric dental patients.

Eur Arch Paediatr Dent 2011 Apr 12(2) 93-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21473840

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Conservative Management of Achilles Tendon Wounds: Results of a Retrospective Study.

Kleinman Y, Cahn A

Achilles tendon wounds are therapeutically challenging. The tendon`s functional importance, the paucity of soft tissue surrounding the ankle, and common patient comorbidities often limit surgical reconstructive procedure options. Depending on wound depth and overall patient health, secondary intention healing of these wounds can take many months. At the authors’ wound care center, patients who are referred with recalcitrant, deep Achilles tendon wounds and who are able to visit the center two to three times per week are offered a protocol of topical hyperbaric oxygen (THBO) followed by low-level laser therapy (LLLT) and moisture-retentive dressings. A retrospective study was conducted to evaluate the outcomes of patients who received treatment for a deep Achilles tendon wound during the years 2004 through 2008. Patients who were seen but did not obtain care at the center were contacted via telephone. Of the 80 patients seen, 15 were referred for amputation, 52 obtained treatment elsewhere, and 13 received the THBO/LLLT protocol. Patient median age was 73 years (range 52-90 years) and most (85%) had diabetes mellitus. Average wound size was 90 cm2 (range 6.25-300 cm2) with an average duration of 11.7 months (range 2-60 months) before treatment. Complete re-epithelialization was achieved in 10 patients (77%) following a mean treatment time of 19 +/- 10 weeks (range 5-42 weeks). Of those, seven remained ambulatory and ulcer-free at mean follow-up of 3.3 +/- 1.8 years. Eight of the 52 patients (15%) who were not treated in the authors’ center reported their ulcer was healed and 15 (29%) underwent amputation. Considering the severity of these wounds, the observed treatment outcomes are encouraging and may present a reasonable alternative for some patients with Achilles tendon wounds. Research is needed to clarify the role of these modalities in the conservative treatment of patients with Achilles tendon ulceration.

Ostomy Wound Manage 2011 Apr 57(4) 32-40

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21512191

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Effect of intraoral low-level laser therapy on quality of life of patients with head and neck cancer undergoing radiotherapy.

Oton-Leite AF, Correa de Castro AC, Morais MO, Pinezi JC, Leles CR, Mendonca EF

Department of Oral Medicine (Oral Pathology), Dental School, Federal University of Goias, Goiania, Brazil.

BACKGROUND: Low-level laser therapy has been used to reduce complications of head and neck cancer treatment. The aim was to assess the impact of laser in the quality of life (QOL) of patients receiving radiotherapy. METHODS: Sixty outpatients were randomly assigned into 2 groups. The laser group received applications and the placebo group received sham laser. QOL was assessed using the University of Washington QOL questionnaire. A repeated-measures analysis of variance (ANOVA) was used for comparisons of overall QOL scores and Mann-Whitney test compared changes in domain scores. RESULTS: A decrease in QOL scores was observed in both groups and the reduction in the laser group was significantly lower (p < .01). Changes in QOL scores regarding pain, chewing, and saliva domains were evident in the placebo group. Both health-related QOL and overall QOL were rated higher by patients who received laser therapy. CONCLUSION: Laser therapy reduces the impact of radiotherapy on the QOL of patients with head and neck cancer. (c) 2011 Wiley Periodicals, Inc. Head Neck, 2011.

Head Neck 2011 Apr 5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21472883

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The diabetic foot and leg: combined He-Ne and infrared low-intensity lasers improve skin blood perfusion and prevent potential complications. A prospective study on 30 Egyptian patients.

Saied GM, Kamel RM, Labib AM, Said MT, Mohamed AZ

Departments of Internal Medicine and General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt, gamal44@hotmail.com.

The objective of this study was to examine skin blood flow in diabetic patients having disease-related skin lesions, and to evaluate possible improvement imposed by low-intensity laser therapy (LILT) as a new treatment modality. Thirty patients (in addition to 15 controls receiving conventional treatment = group II and 15 others receiving no treatment = group III) having diabetes-related skin lesions were tested for skin blood flow by laser Doppler flowmetry. Group I patients received LILT by a specified dosimetry. This was by combined uniform He-Ne and infrared lasers delivered by a scanner over the affected area. This study used a paired t test to determine the significance of blood flow recovery after treatment within each group while Independent t test compared results between the three groups. The level of significance was p < 0.05. The most frequently detected diabetes specific skin lesions were dryness, nail changes, hair loss, infections, itching, and frank eczema-like reactions, mostly in combinations (76%). This pattern appears specific for Egyptians as it is different from data registered in foreign literature. The minimum perfusion flow improved from 16.45 before LILT to 25.94 after, while maximum flow recovered from 32.91 to 48.47 and basal perfusion changed from 24.68 to 34.84 blood perfusion units. The percentage change in perfusion values was 23.17. All these were statistically significant. The study demonstrates that diabetes-linked skin lesions have a special pattern in Egyptians and are apparently caused by deranged skin blood flow .The deficit is measurable by laser flowmetry and can be partially reversed by LILT.

Lasers Med Sci 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21455785

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Use of laser phototherapy on a delayed wound healing of oral mucosa previously submitted to radiotherapy: case report.

Ramalho KM, Luiz AC, de Paula Eduardo C, Tuner J, Magalhaes RP, Gallottini Magalhaes M

KM Ramalho, PhD, Stomatology Department, School of Dentistry, University of Sao Paulo (USP), Sao Paulo, Brazil AC Luiz, PhD Student, Special Care Dentistry Center (CAPE), Department of Oral Pathology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil C de P Eduardo, PhD, Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil J Tuner, DDS, Private practice, Grangesberg, Sweden RP de Magalhaes, PhD, Department of Head and Neck Surgery, Hospital of Clinics, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil M Gallottini Magalhaes, PhD, Special Care Dentistry Center (CAPE), Department of Oral Pathology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.

Radiotherapy produces both acute and delayed effects on mucosal tissues, disturbing their healing. This report shows a successful treatment with laser phototherapy (LPT) on a delayed wound healing in oral mucosa previously submitted to radiotherapy with a follow up of 3 years. A 47-year-old patient treated 6 months earlier for tongue squamous cell carcinoma by surgery and radiotherapy presented with a mass in the operated area. Biopsy showed chronic inflammatory infiltrate around a residual polyglactin suture. After 2 months there was a painful mucosal dehiscence on the biopsy site. LPT was performed using a semiconductor laser with 660-nm wavelength (InGaAlP) and spot size of 0.04 cm(2) . The parameters applied were 40 mW, 4 Jcm(2) /point, 0.16 J/point, 2.4 J/session. The irradiation was performed punctually, through contact mode in 15 points (4 seconds/point), on top of and around the lesion, during ten sessions. The wound healed completely after ten sessions. This treatment proved to be conservative and effective, inducing healing of a chronic wound in a tissue previously submitted to radiotherapy.

Int Wound J 2011 Apr 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21496209

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Chemotherapy-induced oral mucositis in a patient with acute lymphoblastic leukaemia.

Rimulo AL, Ferreira MC, Abreu MH, Aguirre-Neto JC, Paiva SM

Meire Coelho Ferreira. Dept Paediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Av. Antonio Carlos 6627, Belo Horizonte, MG, 31270-901, Brazil. Email: meirecofe@ig.com.br.

BACKGROUND: Oral mucositis is the main complication of chemotherapy and radiotherapy used in the treatment of cancer. Phototherapy has proven effective in the treatment of mucositis, as it accelerates the tissue healing process and has both analgesic and anti-inflammatory properties. CASE REPORT: This paper reports the case of a paediatric patient with oral mucositis stemming from chemotherapy employed for the treatment of acute lymphoblastic leukaemia. TREATMENT: The lesions were treated daily with a light-emitting diode (LED). FOLLOWUP: Remission of the lesions occurred after 10 days of treatment. CONCLUSIONS: LED was effective in the treatment of mucositis, as it diminished pain symptoms and accelerated the tissue repair process.

Eur Arch Paediatr Dent 2011 Apr 12(2) 124-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21473846

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Low level laser therapy in oral mucositis: a pilot study.

Cauwels RG, Martens LC

Dr Rita Cauwels. Dept Paediatric Dentistry, University Hospital (P8), De Pintelaan 158, B 9000 Ghent, Belgium. Email: rita.cauwels@ugent.be.

AIM: The goal of this pilot study was to investigate the capacity of pain relief and wound healing of low level laser therapy (LLLT) in chemotherapy-induced oral mucositis (OM) in a paediatric oncology population group. STUDY DESIGN AND METHODS: 16 children (mean age 9.4 years) from the Gent University Hospital – Department Paediatric Oncology/haematology, suffering from chemotherapy-induced OM were selected. During clinical investigations, the OM grade was assessed using the WHO classification. All children were treated using a GaAlAs diode laser with 830 nm wavelength and a potency of 150 mW. The energy released was adapted according to the severity of the OM lesions. The same protocol was repeated every 48 hrs until healing of each lesion occurred. Subjective pain was monitored before and immediately after treatment by an appropriate pain scale and functional impairment was recorded. At each visit, related blood cell counts were recorded. RESULTS: After 12 mths, records were evaluated and information about treatment sequence, treatment sessions and frequencies related to the pain sensation and comfort were registered. Immediately after beaming the OM, pain relief was noticed. Depending on the severity of OM, on average, 2.5 treatments per lesion in a period of 1 week were sufficient to heal a mucositis lesion. CONCLUSIONS: LLLT, one of the most recent and promising treatment therapies, has been shown to reduce the severity and duration of mucositis and to relieve pain significantly. In the present study similar effects were obtained with the GaAlAs 830nm diode laser. It became clear that using the latter diode device, new guidelines could be developed as a function of the WHO-OM grades i.e. the lower the grade, the less energy needed. Immediate pain relief and improved wound healing resolved functional impairment that was obtained in all cases.

Eur Arch Paediatr Dent 2011 Apr 12(2) 118-23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21473845

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[Intravenous laser irradiation of blood for the combined treatment of patients presenting with chronic sensorineural hearing loss.]

Zhuravlev AS, Krylova2 IV, Bluvshtein GM, Demina EV

Kafedra otorinolaringologii Khar’kovskogo natsional’nogo meditsinskogo universiteta, Khar’kov.

A method for the treatment of chronic sensorineural hearing loss (CSNHL) is proposed that includes administration of trental followed by intravenous laser irradiation of blood (IVLBI). The study included 81 patients at the age from 20 to more than 60 years presenting with CSNHL. They were allocated to three groups; the patients in group 1 (n=32) were given trental intravenously followed by intravenous laser irradiation of blood, those of group 2 (n=24) were treated with IVLBI alone while patients of group 3 (n=25) received “traditional” treatment. Audiometric examination and rheoencephalography were carried out before and after therapy. The hearing improved to 18-20 dB in group 1, to 10-15 dB in group 2, and to 10 dB in group 3. The improvement of rheoencephalographic characteristics was documented in the patients of all groups but was especially pronounced in group 1. It is concluded that the proposed method significantly increases the efficiency of treatment of chronic sensorineural hearing loss.

Vestn Otorinolaringol 2011 (2) 43-45

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21512485

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Effects of 635nm light-emitting diode irradiation on angiogenesis in CoCl(2) -exposed HUVECs.

Lim WB, Kim JS, Ko YJ, Kwon H, Kim SW, Min HK, Kim O, Choi HR, Kim OJ

Department of Oral Pathology, 2nd Stage of Brain Korea 21 for School of Dentistry, Dental Science Research Institute, Chonnam National University, Bug-Gu, Gwangju, Korea.

BACKGROUND AND OBJECTIVES: It is recognized that hypoxic/ischemic conditions leading to production of reactive oxygen species (ROS) are an important mediator of angiogenesis in the wound-healing process. Recently, low level light irradiation at 635 nm, which is used in many clinical fields, was found to decrease intracellular ROS levels, and consequently alleviate oxidative stress. The purpose of the present study was to investigate the effects of 635 nm light-emitting diode (LED) irradiation on angiogenesis in human umbilical vein endothelial cells, in an in vitro CoCl(2) -induced severe hypoxia model. STUDY DESIGN/MATERIALS AND METHODS: The effects were assessed on cell viability, tube formation, hypoxia-inducible factor-1, vascular endothelial growth factor (VEGF), VEGF-1 and -2 protein expression, mitogen-activated protein kinase (MAPK) phosphorylation, and ROS dissociation. RESULTS: The results showed that, under hypoxic/ischemic conditions, irradiation with 635 leads to reduced production and increased scavenging of intracellular ROS, which results in alleviation of VEGFR-1 suppression, enhanced VEGF expression and ERK MAPK activation, and subsequent acceleration of angiogenesis with improved cell viability and tube formation. CONCLUSION: Taken together, irradiation with 635 nm was shown to reduce intracellular ROS production, which results in increased angiogenesis. Thus, we suggest that irradiation with 635 nm accelerate angiogenesis under hypoxic/ischemic conditions, and may prove to be a useful alternative tool in wound healing. Lasers Surg. Med. 43:344-352, 2011. (c) 2011 Wiley-Liss, Inc.

Lasers Surg Med 2011 Apr 43(4) 344-52

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21500230

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Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation.

Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, Ramos L, de Moura Messias F, Lopes-Martins RA

Laboratory of Pharmacology and Experimental Therapeutics, Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil, 05508-900.

Arthritis of the knee is the most common type of joint inflammatory disorder and it is associated with pain and inflammation of the joint capsule. Few studies address the effects of the 810-nm laser in such conditions. Here we investigated the effects of low-level laser therapy (LLLT; infrared, 810-nm) in experimentally induced rat knee inflammation. Thirty male Wistar rats (230-250 g) were anesthetized and injected with carrageenan by an intra-articular route. After 6 and 12 h, all animals were killed by CO(2) inhalation and the articular cavity was washed for cellular and biochemical analysis. Articular tissue was carefully removed for real-time PCR analysis in order to evaluate COX-1 and COX-2 expression. LLLT was able to significantly inhibit the total number of leukocytes, as well as the myeloperoxidase activity with 1, 3, and 6 J (Joules) of energy. This result was corroborated by cell counting showing the reduction of polymorphonuclear cells at the inflammatory site. Vascular extravasation was significantly inhibited at the higher dose of energy of 10 J. Both COX-1 and 2 gene expression were significantly enhanced by laser irradiation while PGE(2) production was inhibited. Low-level laser therapy operating at 810 nm markedly reduced inflammatory signs of inflammation but increased COX-1 and 2 gene expression. Further studies are necessary to investigate the possible production of antiinflammatory mediators by COX enzymes induced by laser irradiation in knee inflammation.

Lasers Med Sci 2011 Apr 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21484455

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Effects of photobiostimulation on edema and hemorrhage induced by Bothrops moojeni venom.

Nadur-Andrade N, Barbosa AM, Carlos FP, Lima CJ, Cogo JC, Zamuner SR

Laboratory of Physiology and Pharmacology, Institute of Research and Development, University of Vale do Paraiba, Sao Jose dos Campos, Brazil.

Antivenom (AV) treatment has been ineffective in neutralizing the severe local fast-developing tissue damage following snake-bite envenoming. We studied the effectiveness of low-level laser (LLL) and light-emitting diode (LED) irradiation alone or in combination with AV in reducing local edema formation and hemorrhage induced by Bothrops moojeni venom (BmV) in mice. Edema formation was induced by injection of 1 mug per paw of BmV into the right paw and was evaluated before and at several intervals after BmV intraplantar injection. Hemorrhagic activity was evaluated after intradermal injection of 20 mug of BmV by measuring the diameter of the hemorrhagic area on the inner side of the skin. The site of BmV injection was irradiated by LLL or LED 30 min after BmV inoculation. AV was also administered intravenously 30 min after BmV injection. Irradiation with LLL at a wavelength of 685 nm and a dose of 2.2 J/cm(2) and with a red LED and an infrared LED at wavelengths of 635 nm and 945 nm, respectively, and a dose of 4 J/cm(2) reduced edema formation and hemorrhage induced by BmV (p < 0.05). The combined AV and LLL or LED treatment showed the same reduction as LLL or LED irradiation separately. In conclusion, both LLL and LED irradiation reduced venom-induced local effects even though symptoms were already present. Thus, the effect of phototherapy in reducing local effects induced by BmV may be clinically relevant.

Lasers Med Sci 2011 Apr 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21484453

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Infrared radiation has potential antidepressant and anxiolytic effects in animal model of depression and anxiety.

Tanaka Y, Akiyoshi J, Kawahara Y, Ishitobi Y, Hatano K, Hoaki N, Mori A, Goto S, Tsuru J, Matsushita H, Hanada H, Kodama K, Isogawa K, Kitamura H, Fujikura Y

Department of Neuropsychiatry, Oita University Faculty of Medicine, Hasama-Machi, Yufu-Shi, Oita, Japan.

BACKGROUND: Bright light therapy has been shown to have antidepressant and anxiolytic effects in humans. OBJECTIVE: The antidepressant and anxiolytic effects of infrared radiation were evaluated using an experimental animal model. METHODS: Rats were randomly assigned to either an acutely or chronically exposed infrared radiation group or to a nonexposed control group. Acutely exposed rats were treated with an infrared radiation machine for one session, whereas chronically exposed animals were treated with an infrared radiation for 10 sessions. Control group rats were exposed to the sound of the infrared radiation machine as a sham treatment. After infrared radiation or control exposure, rats underwent behavioral evaluation, including elevated plus maze test, light/dark box, and forced swim test. RESULTS: Chronic infrared radiation exposure decreased indicators of depression- and anxiety-like behavior. No significant effect on general locomotor activity was observed. The number of BrdU-positive cells in CA1 of the hippocampus was significantly increased in both acutely and chronically exposed infrared radiation groups compared with the control group. CONCLUSIONS: These results indicate that chronic infrared radiation might produce antidepressant- and anxiolytic-like effects.

Brain Stimul 2011 Apr 4(2) 71-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21511206

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Penetration of laser light through red blood cell ghosts.

Sikurova L, Balis P, Zvarik M

Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Computer Science, Comenius University, Mlynska dolina F1, 84248 Bratislava, Slovak Republic.

Hemoglobin is the main absorber of visible light in blood and blood-perfused tissues. However, hemoglobin is released from a red blood cell (RBC) during hemolysis. Hemolysis may be caused by a large number of medical conditions, including photodynamic therapy (PDT) and this subsequently can affect passage of light through the treated biological structures. The purpose of the present study was to determine the penetration of a laser beam through a suspension of hemoglobin-free human red blood cells (RBCs) – ghosts. Although hemoglobin has been efficiently removed from the samples used in our experiments, our measurements show that the samples still effectively attenuate the radiant power of penetrating laser light. We established penetration depths of 12.6mm and 15.4mm for two different laser light wavelengths, 532nm and 630nm, respectively. The penetration depth of laser light was about one order of magnitude higher for hemoglobin-free RBC ghosts as compared to intact RBCs [8,10,12]. These results can be important in case of phototherapy or biostimulation, since all photons that penetrate in a biological object may interact with it and evoke biological response.

J Photochem Photobiol B 2011 Mar 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21501961

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Determination of coherence length in biological tissues.

Fixler D, Duadi H, Ankri R, Zalevsky Z

School of Engineering, Bar Ilan University, Ramat Gan 52900, Israel.

BACKGROUND AND OBJECTIVE: Lately in phototherapy the use of diodes instead of lasers was suggested for economical and practical reasons. It has been argued that lasers have no preference over diodes since they lose their coherence once penetrating biological tissues. However, this point has never been experimentally proven. In this work we, for the first time, have experimentally validated the conditions affecting the spatial coherence of a laser illumination going through a biological tissue. STUDY DESIGN/MATERIALS AND METHODS: In our experiments we measured the spatial coherence of the light passing through phantoms containing intralipid and ink component as well as through uncooked turkey meat. We do this measuring the changes of the contrast of the speckle patterns generated due to laser illumination. Flow tunnels inside the phantoms were generated by needles in two different diameters. The measurements were performed for varied integration time, varied thickness of phantoms, and for varied flow rates. The measurement system included two excitation sources: a green doubled Nd:YAG laser at wavelength of 532 nm and an ultra high power green LED at a wavelength of 520 nm. RESULTS: It was experimentally validated that the thickness of the tissue does not change the coherence while there is no flow. Furthermore, the flow velocity and the flow volumetric rate highly affect the coherence length. Previously developed mathematical expression, in which the contrast depends on the correlation and the exposure time, was found to be compatible with the obtained experimental results. CONCLUSIONS: We found that the coherence of the laser is not lost when the light goes through a static tissue but it is partially lost when there is a flow of fluid through the tissue. The volumetric flow rate is directly correlated to the loss of spatial coherence. Higher flow rate produces shorter coherence length. Lasers Surg. Med. 43:339-343, 2011. (c) 2011 Wiley-Liss, Inc.

Lasers Surg Med 2011 Apr 43(4) 339-43

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21500229

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Lasers in dental traumatology and low level laser therapy (LLLT).

Caprioglio C, Olivi G, Genovese MD

Paediatric Dentistry, University of Parma, Parma, Italy. Email: ac.caprioglio@tin.it.

BACKGROUND: Dental trauma in children is a frequent and often complex clinical event in which laser-assisted therapy, particularly using erbium lasers, can offer new treatment possibilities, improving the outcomes and reducing the associated complications. REVIEW: In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. Laser anaesthesia is another interesting and challenging area. CONCLUSION: Given the paucity of data on laser-assisted dental trauma therapy in the international literature and the absence of well-structured guidelines, this is an area ripe for scientific research.

Eur Arch Paediatr Dent 2011 Apr 12(2) 79-84

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21473837

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Laser physics and a review of laser applications in dentistry for children.

Martens LC

Prof L.C. Martens. Dept Paediatric Dentistry, De Pintelaan 187 (P8) B – 9000 Ghent, Belgium. Email: luc.martens@ugent.be.

AIM: The aim of this introduction to this special laser issue is to describe some basic laser physics and to delineate the potential of laser-assisted dentistry in children. REVIEW: A brief review of the available laser literature was performed within the scope of paediatric dentistry. Attention was paid to soft tissue surgery, caries prevention and diagnosis, cavity preparation, comfort of the patient, effect on bacteria, long term pulpal vitality, endodontics in primary teeth, dental traumatology and low level laser therapy. Although there is a lack of sufficient evidence taking into account the highest standards for evidence-based dentistry, it is clear that laser application in a number of different aetiologies for soft tissue surgery in children has proven to be successful. Lasers provide a refined diagnosis of caries combined with the appropriate preventive adhesive dentistry after cavity preparation. This will further lead to a new wave of micro-dentistry based on ‘filling without drilling’. CONCLUSION: It has become clear from a review of the literature that specific laser applications in paediatric dentistry have gained increasing importance. It can be concluded that children should be considered as amongst the first patients for receiving laser-assisted dentistry.

Eur Arch Paediatr Dent 2011 Apr 12(2) 61-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21473835

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Transcriptional regulation of bone sialoprotein gene by CO(2) laser irradiation.

Sasaki Y, Wang S, Ogata Y

Department of Periodontology, Nihon University School of Dentistry at Matsudo.

Bone sialoprotein (BSP), an early marker of osteoblast differentiation, has been implicated in the nucleation of hydroxyapatite during de novo bone formation. Low-power laser irradiation has a stimulating effect on cells and tissues. Although the carbon dioxide (CO(2)) laser is a hard surgical laser, we have attempted to use it at low energy density to achieve biological alterations. To investigate the effects of CO(2) laser irradiation on BSP gene transcription, we used rat osteoblast-like ROS17/2.8 cells. BSP mRNA levels were increased at 12 h after irradiation with the CO(2) laser (2 W, 20 s). Transient transfection assays using various sizes of the rat BSP gene promoter linked to the luciferase reporter gene showed that CO(2) laser irradiation induced luciferase activity of a -116 to +60 BSP promoter construct (pLUC3) at 12 h in the cells. Transcriptional stimulation by CO(2) laser irradiation was abrogated in the pLUC3 construct containing a 2-bp mutation in the fibroblast growth factor 2 response element (FRE). Gel shift analyses showed that CO(2) laser irradiation increased the binding of nuclear protein to FRE. These studies demonstrate that CO(2) laser irradiation increases BSP transcription via FRE in the rat BSP gene promoter. (J Oral Sci 53, 51-59, 2011).

J Oral Sci 2011 53(1) 51-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21467815

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Investigation of irradiation by different nonablative lasers on primary cultured skin fibroblasts.

Weng Y, Dang Y, Ye X, Liu N, Zhang Z, Ren Q

School of Life Science, East China Normal University,Shanghai, China; and *Institute for Laser Medicine and Bio-Photonics, Shanghai Jiaotong University, Shanghai, China.

Background. A variety of lasers with different wavelengths and biological effects are widely used for nonablative skin rejuvenation, but the underlying mechanisms have not been fully investigated. Aim. To investigate the effects of irradiation by different nonablative lasers on collagen synthesis and the antioxidant status of cultured fibroblasts to identify a possible mechanism for laser photorejuvenation. Methods. Cultured skin fibroblasts were irradiated with three different lasers: 532 nm potassium-titanyl phosphate (KTP), 1064 nm Q-switched neodymium:yttrium-aluminium-garnet (Nd:Yag) and 1064 nm long-pulse Nd:YAG, and production of collagen and changes in lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were assayed. Results. Irradiation by all three lasers led to a marked increase in collagen production. Two major antioxidant enzymes, SOD and GSH, were significantly increased, whereas MDA was markedly reduced after laser irradiation. No change in LDH activity was found between nonirradiated and irradiated fibroblasts. Conclusion. This study indicates that the increased collagen synthesis by fibroblasts after laser treatment may be partly due to improved antioxidant capacity, which reduces oxidative stress and thus stimulates new collagen production.

Clin Exp Dermatol 2011 Apr 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21457156

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Evaluation of Laser Phototherapy in the Inflammatory Process of the Rat’s TMJ Induced by Carrageenan.

Carvalho CM, Lacerda JA, Dos Santos Neto FP, de Castro IC, Ramos TA, de Lima FO, de Cerqueira Luz JG, Ramalho MJ, Dos Santos JN, Pinheiro AL

1 Center of Biophotonics, School of Dentistry, Federal University of Bahia , Salvador, BA, Brazil .

Abstract Aim: The aim of this study was to evaluate, by light microscopy, the effects of laser phototherapy (LPT) at 780 nm or a combination of 660 and 790 nm, on the inflammatory process of the rat temporomandibular joint (TMJ) induced by carrageen. Background: Temporomandibular disorders (TMDs) are frequent in the population and generally present an inflammatory component. Previous studies have evidenced positive effects of laser phototherapy on TMDs. However, its mechanism of action on the inflammation of the TMJ is not known yet. Materials and Methods: Eighty-five Wistar rats were divided into 9 groups: G1, Saline; G2, Saline + LPT IR; G3, Saline + LPT IR + R; G4, Carrageenan; G5, Carrageenan + LPT IR; G6, Carrageenan + LPT IR + R; G7, previous LPT + Carrageenan; G8, previous LPT + carrageenan + LPT IR; and G9, previous LPT + carrageenan + LPT IR + R, and then subdivided in subgroups of 3 and 7 days. After animal death, specimens were taken, routinely cut and stained with HE, Sirius Red, and Toluidine Blue. Descriptive analysis of components of the TMJ was done. The synovial cell layers were counted. Results: Injection of saline did not produced inflammatory reaction and the irradiated groups did not present differences compared to nonirradiated ones. After carrageenan injection, intense inflammatory infiltration and synovial cell layers proliferation were observed. The infrared irradiated group presented less inflammation and less synovial cell layers number compared to other groups. Previous laser irradiation did not improve the results. Conclusion: It was concluded that the LPT presented positive effects on inflammatory infiltration reduction and accelerated the inflammation process, mainly with IR laser irradiation. The number of synovial cell layers was reduced on irradiated group.

Photomed Laser Surg 2011 Apr 29(4) 245-54

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21457090

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Low-Level Laser Therapy (LLLT) at 830 nm Positively Modulates Healing of Tracheal Incisions in Rats: A Preliminary Histological Investigation.

Grendel T, Sokolsky J, Vascakova A, Hrehova B, Polakova M, Bobrov N, Sabol F, Gal P

1 Department of Medical Biophysics, Pavol Jozef Safarik University , Kosice, Slovak Republic .

Abstract Objective: The aim of the present study was to evaluate whether LLLT at 830 nm is able to positively modulate trachea incisional wound healing in Sprague-Dawley rats. Background data: Tracheotomy may be associated with numerous complications. Development of excess granulation tissue represents a late complication that may lead to airway occlusion. Low-level laser therapy (LLLT) has been shown to have stimulatory effects on wound healing of different tissues. Therefore, it may be suggested that LLLT could be able to positively modulate trachea wound healing as well. Materials and methods: Using general anesthesia, a median incision was performed from the second to the fifth tracheal cartilage ring in 24 rats. Animals were then randomly divided into sham-irradiated control and laser-treated groups. LLLT (power density: 450 mW/cm(2); total daily dose: 60 J/cm(2); irradiated area approximately 1 cm(2)) treatment was performed daily during the first week after surgery. Samples for histological evaluation were removed 7 and 28 days after surgical procedure. Histological sections were stained with hematoxylin-eosin and van Gieson. Results: Results from our investigation showed that LLLT was able to reduce granulation tissue formation and simultaneously increase new cartilage development at both evaluated time intervals. Conclusions: From this point of view, LLLT at 830 nm may be a valuable tool in trachea wound healing modulation. Nevertheless, further detailed research is needed to find optimal therapeutic parameters and to test these findings on other animal models.

Photomed Laser Surg 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21456943

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

das Neves LM, Marcolino AM, Prado RP, De Souza Ribeiro T, Pinfildi CE, Thomazini JA

1 Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, University of Sao Paulo-FMRP/USP , Ribeirao Preto, Brazil .

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

Photomed Laser Surg 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21456941

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Effect of Ga-As (904nm) and He-Ne (632.8nm) laser on injury potential of skin full-thickness wound.

Sanati MH, Torkaman G, Hedayati M, Dizaji MM

Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran.

Injury potential may have a triggering biological role in wound healing. In this study, the effect of photostimulation to promote wound healing and its effect on injury potential was investigated using the Ga-As and He-Ne lasers. In this study, 30healthy male Sprague-Dawley rats were randomly divided into a control and two laser groups, He-Ne and Ga-As laser. A 2.5cm craniocaudal full-thickness skin incision was made on each animal’s dorsal region. Differential skin surface potential was measured before and immediately after the injury and also up to the 21st day, every other day. Wound surface area was also measured. Immediately after injury, wound potential significantly increased in all three groups. Maximum positive peak of injury potential was greater in Ga-As group compared to He-Ne laser and control groups (P<0.05) and lasting period of maximum positive potential in two laser groups was longer than that in the control group. There were no significant differences between the mean potential of before wounding and after the 15th, 17th, and 19th day in Ga-As, He-Ne, and control group, respectively (P>0.05). On the other hand, Ga-As and He-Ne laser facilitated the normal distribution of skin potential after wounding. These findings demonstrate that Ga-As laser may be more effective on wound closure and on returning the injury potential to normal level than the He-Ne laser.

J Photochem Photobiol B 2011 May 3 103(2) 180-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21450490

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Pressure ulcers.

Reddy M

Geriatric Medicine, University of California, San Francisco, USA.

INTRODUCTION: Unrelieved pressure or friction of the skin, particularly over bony prominences, can lead to pressure ulcers in up to one third of people in hospitals or community care, and one fifth of nursing home residents. Pressure ulcers are more likely in people with reduced mobility and poor skin condition, such as older people or those with vascular disease. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in people at risk of developing pressure ulcers? What are the effects of treatments in people with pressure ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 64 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: air-filled vinyl boots, air-fluidised supports, alternating-pressure surfaces (including mattresses), alternative foam mattresses, constant low-pressure supports, debridement, electric profiling beds, electrotherapy, hydrocellular heel supports, low-air-loss beds (including hydrotherapy beds), low-level laser therapy, low-tech constant-low-pressure supports, medical sheepskin overlays, nutritional supplements, orthopaedic wool padding, pressure-relieving overlays on operating tables, pressure-relieving surfaces, repositioning (regular “turning”), seat cushions, standard beds, standard care, standard foam mattresses, standard tables, surgery, therapeutic ultrasound, topical lotions and dressings, topical negative pressure, and topical phenytoin.

Clin Evid (Online) 2011 2011

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21524319

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Early and long-term results of physical methods in the treatment of venous leg ulcers: randomized controlled trial.

Taradaj J, Franek A, Cierpka L, Brzezinska-Wcislo L, Blaszczak E, Polak A, Chmielewska D, Krol P, Dolibog P, Kucio C

Department of Medical Biophysics, Medical University of Silesia in Katowice.

OBJECTIVE: To estimate early and long-term results of physical methods in the treatment of venous leg ulcers. METHOD: In group A after surgical operation, 40 patients were treated with the high-voltage stimulation (HVS) (100 micros, 100 Hz, 100 V) and drug therapy. In group B after operation, 37 patients were treated with ultrasound (0.5 W/cm(2), 1 MHz) and drug therapy. In group C after operation, 33 patients were treated with low-level laser therapy (LLLT) (810 nm, 65 mW) and drug therapy. In group D after operation, 35 patients were treated with the compression stockings (25-31 mmHg) and drug therapy. In group E after operation, 37 patients were only treated with drug therapy. Group F consisted of 32 patients, conservatively treated with the HVS and drug therapy. Group G consisted of 20 patients, conservatively treated with ultrasound and drug therapy. Group H consisted of 21 patients, conservatively treated with LLLT and drug therapy. Group I consisted of 30 patients, conservatively treated with compression and drug therapy. Group J consisted of 27 patients only treated with drug therapy. RESULTS: Both short and long term parameters showed that compression therapy is the most efficient in ulcer healing. The electrical and ultrasound methods are less effective. The laser therapy ared useless. CONCLUSION: Superficial venous surgery in addition to compression therapy is the most efficient treatment of venous leg ulcers. The compression therapy should be continued both surgically and conservatively treated patients with healed ulcers. In special cases after superficial venous surgery (isolated superficial reflux) compression therapy could be applied only to the time of ulcer closure without continuing it longer. HVS and ultrasound therapy are useful methods in conservative treatment of venous leg ulcers. For surgically-treated patients these physical therapies are efficient only in superficial plus deep reflux cases. HVS and ultrasound can be alternative methods, but are less effective in recurrence risk. LLLT is not an efficient physical method in treatment of venous leg ulcers.

Phlebology 2011 Apr 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21478141

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Effect of Low-Level Treatment with an 80-Hz Pulsed Infrared Diode Laser on Mast-Cell Numbers and Degranulation in a Rat Model of Third-Degree Burn.

Khoshvaghti A, Zibamanzarmofrad M, Bayat M

1 Anatomy Department, Medical Faculty, Artesh University of Medical Sciences (AUMS) , Tehran, Iran .

Abstract Background Data: Low-level laser therapy (LLLT) has been reported to be capable of changing mast cell numbers and degranulation in experimental burns in rats. Objective: We conducted a study of the influence of LLLT on mast cells in a rat model of third-degree burn. Methods: In this study we divided 48 rats equally into two groups of 24 rats each. Third-degree burns were inflicted at three different locations on each rat in each group. The first burn site on rats in group I was treated with 890-nm pulsed laser, 75W peak, 80 Hz, 180 ns, average power 1mW, illuminated area 1 cm(2), 1 mW/cm(2), 856 sec, 0.924 J/cm(2). The second burn site on both groups of rats was treated with 0.2% nitrofurazone cream. Mast cell numbers and degranulation at each burn site on each group of rats were then assessed at 4, 8, 13, and 20 days after the infliction of burns. Results: Analysis of variance on day 4 showed that the total numbers of mast cells were significantly lower at the laser-treated burn sites than at other burn sites on both groups of rats. On day 8 the total numbers of mast cells were again significantly lower at the laser-treated burn sites than at other burn sites, and on day 13, the numbers of both types 1 and 2 mast cells were significantly lower at the laser-treated burn sites than at other burn sites. Conclusions: We conclude that LLLT can significantly decrease total numbers of mast cells during the proliferation and remodeling phases of healing in a rat model of third-degree burn.

Photomed Laser Surg 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21456947

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Laser-induced oxidation of cholesterol observed during maldi-tof mass spectrometry.

McAvey KM, Guan B, Fortier CA, Tarr MA, Cole RB

Department of Chemistry, University of New Orleans, 2000 Lakeshore Dr., New Orleans, LA, 70148, USA.

Conditions for the detection of three odd-electron cholesterol oxidation peaks were determined and these peaks were shown to be artifacts of the matrix-assisted laser desorption time of flight (MALDI-TOF) process. Matrix choice, solvent, laser intensity and cholesterol concentration were systematically varied to characterize the conditions leading to the highest signals of the radical cation peaks, and it was found that initial cholesterol solution concentration and resultant density of solid cholesterol on the MALDI target were important parameters in determining signal intensities. It is proposed that hydroxyl radicals, generated as a result of laser irradiation of the employed 2, 5-dihydroxybenzoic acid (DHB) matrix, initiate cholesterol oxidation on the MALDI target. An attempt to induce the odd-electron oxidation peaks by means of adding an oxidizing agent succeeded using an acetonitrile solution of DHB, cholesterol, and cumene hydroperoxide. Moreover, addition of free radical scavengers reduced the abundances of some oxidation products under certain conditions. These results are consistent with the mechanism of oxidation proposed herein involving laser-induced hydroxyl radical production followed by attack on neutral cholesterol. Hydroxyl radical production upon irradiation of dithranol matrix may also be responsible for generation of the same radical peaks observed from cholesterol in dithranol by an analogous mechanism.

J Am Soc Mass Spectrom 2011 Apr 22(4) 659-69

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21472605

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Evidence-based Guideline: Treatment of Painful Diabetic Neuropathy Report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.

Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, Feldman E, Iverson DJ, Perkins B, Russell JW, Zochodne D

OBJECTIVE: To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). METHODS: We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: “What is the efficacy of a given treatment (pharmacological: anticonvulsants, antidepressants, opioids, others; and non-pharmacological: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?” RESULTS AND RECOMMENDATIONS: Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulphate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL.

PM R 2011 Apr 3(4) 345-352.e21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21497321

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Is Effect of Low-Level Laser Therapy in Patients with Burning Mouth Syndrome Result of a Placebo?

Vukoja D, Alajbeg I, Boras VV, Brailo V, Alajbeg IZ, Rogulj AA

1 Dental Unit Zagreb Istok , Svarcova, Zagreb, Croatia .

Photomed Laser Surg 2011 Apr 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21492001

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Medical devices; general and plastic surgery devices; classification of the low level laser system for aesthetic use. Final rule.

The Food and Drug Administration (FDA) is classifying the low level laser system for aesthetic use into class II (special controls). The special control(s) that will apply to the device is entitled “Class II Special Controls Guidance Document: Low Level Laser System for Aesthetic Use.” The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document that will serve as the special control for this device type.

Fed Regist 2011 Apr 14 76(72) 20840-2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21491809

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Evidence-based guideline: Treatment of painful diabetic neuropathy-report of the american association of neuromuscular and electrodiagnostic medicine, the american academy of neurology, and the american academy of physical medicine & rehabilitation.

Bril V, England JD, Franklin GM, Backonja M, Cohen JA, Del Toro DR, Feldman EL, Iverson DJ, Perkins B, Russell JW, Zochodne DW

University Health Network, University of Toronto, Toronto, Ontario, Canada. aanem@aanem.org.

The objective of this report was to develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). The basic question that was asked was: “What is the efficacy of a given treatment (pharmacological: anticonvulsants, antidepressants, opioids, others; non-pharmacological: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?” A systematic review of literature from 1960 to August 2008 was performed, and studies were classified according to the American Academy of Neurology classification of evidence scheme for a therapeutic article. Recommendations were linked to the strength of the evidence. The results indicate that pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence, or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness. Few studies have sufficient information on their effects on function and QOL. Muscle Nerve, 2011.

Muscle Nerve 2011 Mar 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21484835

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Epicondyilis: etiology, pathogenesis and therapy.

Emilio Salvi A, Teresa Donini M, Campochiaro G, Corona M, Dakovic I

Epicondilites are pathologies poorly understood from the aetiopathogenetic point of view. In this regard, many hypotheses have been considered and numerous anatomical structures are involved. Current therapeutic options are either conservative or surgical. Conservative treatments are: immobilization of the elbow flexed at 90-degrees, stretching the forearm muscles, manipulating the wrist, the application of low-energy extracorporeal shock waves, acupuncture, autologous blood injection under the extensor carpi radialis brevis, laser therapy and pulsed electromagnetic field therapy. Surgical treatments are: fasciotomy, excision of angiofibroblastic hyperplasias located at the origin of extensor carpi radialis brevis, partial release of the orbicular ligament, release of the extensor muscles, elongation of the tendon of extensor carpi radialis brevis and arthroscopic treatment. Advantages and disadvantages are described for each treatment according to the international literature.

Tunis Med 2011 Apr 89(4) 320-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21484678

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Evidence-based guideline: Treatment of painful diabetic neuropathy: Report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation.

Bril V, England J, Franklin GM, Backonja M, Cohen J, Del Toro D, Feldman E, Iverson DJ, Perkins B, Russell JW, Zochodne D

From the University Health Network (V.B., B.P.), University of Toronto, Toronto, Canada; Department of Neurology (J.E.), LSU School of Medicine, New Orleans, LA; University of Washington (G.M.F.), Seattle; University of Wisconsin (M.B.), Madison; Dartmouth Hitchcock Medical Center (J.C.), Lebanon, NH; Department of PM&R (D.D.), Medical College of Wisconsin, Milwaukee; University of Michigan (E.F.), Ann Arbor; Humboldt Neurological Medical Group, Inc. (D.J.I.), Eureka, CA; Department of Neurology (J.W.R.), University of Maryland School of Medicine, Baltimore; and University of Calgary (D.Z.), Calgary, Canada.

OBJECTIVE: To develop a scientifically sound and clinically relevant evidence-based guideline for the treatment of painful diabetic neuropathy (PDN). METHODS: We performed a systematic review of the literature from 1960 to August 2008 and classified the studies according to the American Academy of Neurology classification of evidence scheme for a therapeutic article, and recommendations were linked to the strength of the evidence. The basic question asked was: “What is the efficacy of a given treatment (pharmacologic: anticonvulsants, antidepressants, opioids, others; and nonpharmacologic: electrical stimulation, magnetic field treatment, low-intensity laser treatment, Reiki massage, others) to reduce pain and improve physical function and quality of life (QOL) in patients with PDN?” Results and Recommendations: Pregabalin is established as effective and should be offered for relief of PDN (Level A). Venlafaxine, duloxetine, amitriptyline, gabapentin, valproate, opioids (morphine sulfate, tramadol, and oxycodone controlled-release), and capsaicin are probably effective and should be considered for treatment of PDN (Level B). Other treatments have less robust evidence or the evidence is negative. Effective treatments for PDN are available, but many have side effects that limit their usefulness, and few studies have sufficient information on treatment effects on function and QOL.

Neurology 2011 Apr 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21482920

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Lasers & light therapies for skin rejuvenation.

Tull SS, Raza S

Skin Surgery Center of Missouri, O’Fallon, USA.

There are numerous laser and light technology instruments for cosmetic improvement of skin appearance. New technology is constantly being developed to improve cosmesis, shorten recovery and reduce risk.

Mo Med 2011 Jan-Feb 108(1) 69-72

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21462616

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Noninvasive Body Sculpting Technologies with an Emphasis on High-Intensity Focused Ultrasound.

Jewell ML, Solish NJ, Desilets CS

Jewell Plastic Surgery Center, Oregon Health Science University, 10 Coburg Road, Suite 300, Eugene, OR, 97401, USA, mjewell@teleport.com.

BACKGROUND: Body-sculpting procedures are becoming increasingly popular in the United States. Although surgical lipoplasty remains the most common body sculpting procedure, a demand exists for noninvasive alternatives capable of reducing focal adiposity without the risks of adverse events (AEs) associated with invasive excisional body-sculpting procedures. METHODS: This report describes the mechanism of action, efficacy, safety, and tolerability of cryolipolysis, radiofrequency ablation, low-level external laser therapy, injection lipolysis, low-intensity nonthermal ultrasound, and high-intensity focused ultrasound (HIFU), with an emphasis on thermal HIFU. The articles cited were identified via a PubMed search, with additional article citations identified by manual searching of the reference lists of articles identified through the literature search. RESULTS: Each of the noninvasive treatments reviewed can be administered on an outpatient basis. These treatments generally have fewer complications than lipoplasty and require little or no anesthesia or analgesia. However, HIFU is the only treatment that can produce significant results in a single treatment, and only radiofrequency, low-level laser therapy, and cryolipolysis have been approved for use in the United States. Early clinical data on HIFU support its efficacy and safety for body sculpting. In contrast, radiofrequency, laser therapy, and injection lipolysis have been associated with significant AEs. CONCLUSIONS: The published literature suggests that noninvasive body-sculpting techniques such as radiofrequency ablation, cryolipolysis, external low-level lasers, laser ablation, nonthermal ultrasound, and HIFU may be appropriate options for nonobese patients requiring modest reduction of adipose tissue.

Aesthetic Plast Surg 2011 Apr 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21461627

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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