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THOR on YouTubeDr Robin Falkov interviews Prof. Harry Whelan MD yesterday 26th August 2011 on Rayedio Lounge. Listen here: Harry Whalen Interview LLLT LED 26 Aug 2011
In case you are new to LLLT, Harry Whelan is best known for his association with the NASA related research into LLLT with LEDs Continue reading
Thirty-Three new LLLT papers for you this month including; pretreatment of untrained runners in which LLLT increased performance and reduced oxidative damage, yet another trial on oral mucositis (that is now 14 RCTs according to my calculations), this time using LED extra-orally to cheeks and throat tissues on children undergoing hematopoietic stem cell transplantation, a paper published on LED treatment of cellulite applied during treadmill training claims reduced saddlebag and thigh circumference (controlled, but not a randomised or blinded study).
There is also an in-vitro study on reactive oxygen species (ROS) generation with 810nm laser and its effect on NF-kB (from Harvard). This is important – we all need to learn more about NF-kB, because it governs many cellular functions (including inflammation and cell death); and they found that NF-kB can be stimulated by light induced ROS to protect healthy cells. You may also have heard that oxidative stress (caused by ROS) can also be reversed by treatment with LLLT, how weird is that! This is easily explained but I’m not going to entertain you with it now – come on a THOR training course or attend my introductory session at NAALT 22nd – 24th Sept, Milwaukee, USA and you will begin to understand how this major LLLT mechanism can be triggered, what irradiation parameters work best to achieve this and the vast clinical benefits that result for your patients.
22 new papers for your review. The BMJ clinical evidence recommendations for tennis elbow now include LLLT, next on the list is a systematic review with meta-analysis of LLLT on oral mucositis, this finds reduced pain, severity and duration of OM symptoms. There is also a laser vs ultrasound clinical trial on shoulder myofascial pain, and lab rat studies on red vs IR for laser-induced analgesia, reduced scarring post MI following laser irradiated stem cells transplanted to bone marrow, one on sciatic pain and another study on acute lung inflammation (an adult respiratory distress syndrome model).
Bisset L, Coombes B, Vicenzino B
Department of Health and Rehabilitation, University of Queensland, Brisbane, Australia.
INTRODUCTION: Lateral pain in the elbow affects up to 3% of the population, and is considered an overload injury of the extensor tendons of the forearm where they attach at the lateral epicondyle. Although usually self-limiting, symptoms may persist for over 1 year in up to 20% of people. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for tennis elbow? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (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 80 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: acupuncture, autologous whole blood injections, corticosteroid injections, combination physical therapies, exercise, extracorporeal shock wave therapy, iontophoresis, low-level laser therapy, manipulation, non-steroidal anti-inflammatory drugs (oral and topical), orthoses (bracing), platelet-rich plasma injections, pulsed electromagnetic field treatment, surgery, and ultrasound.
Clin Evid (Online) 2011 2011
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Rayegani SM, Bahrami MH, Samadi B, Sedighipour L, Mokhtarirad MR, Eliaspoor D
Physical Medicine and Rehabilitation Department, Shohada Medical Center, Shaheed Beheshti Medical University of Medical Sciences, Tehran, Iran – bahrami7mh@gmail.com.
BACKGROUND: Myofascial pain syndrome (MPS) is one of the most prevalent musculoskeletal diseases. MPS impaired quality of life in the patients. There is a lot of controversy about different treatment options which include medical treatments, physical therapy, injections, ultrasound and laser. The effects of laser in MPS are challenging. AIM: To assess the effects of laser and ultrasound in treatment of MPS. DESIGN:Randomized single blinded clinical trial SETTING: Outpatient physical therapy clinic at university hospital POPULATION:Sixty three subjects (females: 46, males: 17), (age range: 17-55 year old) who had a RESULTS: Ultrasound was effective in VAS improvement during activity (46%), at rest (39%) and at night (35%). It also improved NDI scores (34%) and algometric assessment (37%). Laser was effective in VAS improving during activity (54%), at night (51%) and at rest (51%) and also improved NDI scores (73%). It was also found effective in algometric assessment improvement (105%). Laser resulted in more NDI score and algometric assessment improvements comparing to ultrasound (p
Eur J Phys Rehabil Med 2011 Jun 13
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Yan W, Chow R, Armati PJ
Neuroinflammation Laboratory, Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.
Low-level laser therapy (LLLT) has been shown in clinical trials to relieve chronic pain and the World Health Organization has added LLLT to their guidelines for treatment of chronic neck pain. The mechanisms for the pain-relieving effects of LLLT are however poorly understood. We therefore assessed the effects of laser irradiation (LI) on somatosensory-evoked potentials (SSEPs) and compound muscle action potentials (CMAPs) in a series of experiments using visible (lambda = 650 nm) or infrared (lambda = 808 nm) LI applied transcutaneously to points on the hind limbs of rats overlying the course of the sciatic nerve. This approximates the clinical application of LLLT. The 650-nm LI decreased SSEP amplitudes and increased latency after 20 min. CMAP proximal amplitudes and hip/ankle (H/A) ratios decreased at 10 and 20 min with increases in proximal latencies approaching significance. The 808-nm LI decreased SSEP amplitudes and increased latencies at 10 and 20 min. CMAP proximal amplitudes and H/A ratios decreased at 10 and 20 min. Latencies were not significantly increased. All LI changes for both wavelengths returned to baseline by 48 h. These results strengthen the hypothesis that a neural mechanism underlies the clinical effectiveness of LLLT for painful conditions.
J Peripher Nerv Syst 2011 Jun 16(2) 130-5
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Tuby H, Maltz L, Oron U
Department of Zoology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv 69978, Israel.
BACKGROUND AND OBJECTIVES: The adult mammalian heart is known to have a very limited regenerative capacity following acute ischemia. In this study we investigated the hypothesis that photobiostimulation of autologous bone-marrow-derived mesenchymal stem cells (MSCs) by low-level laser therapy (LLLT) applied to the bone marrow (BM), may migrate to the infarcted area and thus attenuate the scarring processes following myocardial infarction (MI). MATERIALS AND METHODS: Sprague-Dawley rats underwent experimental MI. LLLT (Ga-Al-As diode laser, power density 10 mW/cm(2) , for 100 seconds) was then applied to the BM of the exposed tibia at different time intervals post-MI (20 minutes and 4 hours). Sham-operated infarcted rats served as control. RESULTS: Infarct size and ventricular dilatation were significantly reduced (76% and 75%, respectively) in the laser-treated rats 20 minutes post-MI as compared to the control-non-treated rats at 3 weeks post-MI. There was also a significant 25-fold increase in cell density of c-kit+ cells in the infarcted area of the laser-treated rats (20 minutes post-MI) as compared to the non-laser-treated controls. CONCLUSION: The application of LLLT to autologous BM of rats post-MI offers a novel approach to induce BM-derived MSCs, which are consequently recruited from the circulation to the infarcted heart and markedly attenuate the scarring process post-MI. Lasers Surg. Med. 43:401-409, 2011. (c) 2011 Wiley-Liss, Inc.
Lasers Surg Med 2011 Jul 43(5) 401-9
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de Lima FM, Villaverde AB, Albertini R, Correa JC, Carvalho RL, Munin E, Araujo T, Silva JA, Aimbire F
Research and Development Institute, Av. Shishima Hifumi, 2911, Sao Jose dos Campos, SP, Brazil. flaviafisio@hotmail.com.
BACKGROUND AND OBJECTIVE: It is unknown if pro- and anti-inflammatory mediators in acute lung inflammation induced by intestinal ischemia and reperfusion (i-I/R) can be modulated by low-level laser therapy (LLLT). STUDY DESIGN/MATERIAL AND METHODS: A controlled ex vivo study was developed in which rats were irradiated (660 nm, 30 mW, 0.08 cm(2) of spot size) on the skin over the right upper bronchus 1 hour post-mesenteric artery occlusion and euthanized 4 hours later. For pretreatment with anti-tumor necrosis factor (TNF) or IL-10 antibodies, the rats received either one of the agents 15 minutes before the beginning of reperfusion. METHODS: Lung edema was measured by the Evans blue extravasation and pulmonary neutrophils influx was determined by myeloperoxidase (MPO) activity. Both TNF and IL-10 expression and protein in lung were evaluated by RT-PCR and ELISA, respectively. RESULTS: LLLT reduced the edema (80.1 +/- 41.8 microg g(-1) dry weight), neutrophils influx (0.83 +/- 0.02 x 10(6) cells ml(-1) ), MPO activity (2.91 +/- 0.60), and TNF (153.0 +/- 21.0 pg mg(-1) tissue) in lung when compared with respective control groups. Surprisingly, the LLLT increased the IL-10 (0.65 +/- 0.13) in lung from animals subjected to i-I/R. Moreover, LLLT (0.32 +/- 0.07 pg ml(-1) ) reduced the TNF-alpha level in RPAECs when compared with i-I/R group. The presence of anti-TNF or IL-10 antibodies did not alter the LLLT effect on IL-10 (465.1 +/- 21.0 pg mg(-1) tissue) or TNF (223.5 +/- 21.0 pg mg(-1) tissue) in lung from animals submitted to i-I/R. CONCLUSION: The results indicate that the LLLT attenuates the i-I/R-induced acute lung inflammation which favor the IL-10 production and reduce TNF generation. Lasers Surg. Med. 43:410-420, 2011. (c) 2011 Wiley-Liss, Inc.
Lasers Surg Med 2011 Jul 43(5) 410-20
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Bertolini GR, Artifon EL, Silva TS, Cunha DM, Vigo PR
Injury and Physiotherapeutic Resource Study Laboratory, Western Parana State University, Cascavel, PR, Brazil.
Chronic pain, resulting from nerve compression, is a common clinical presentation. One means of conservative treatment is low-level laser therapy, although controversial. The aim of this study was to evaluate the effects of two doses of low-level laser, at 830 nm, on pain reduction in animals subjected to sciatica. Eighteen rats were used, divided into three groups: GS (n=6), sciatica and simulated treatment; G4J (n=6), sciatica and treatment with 4 J/cm(2); and G8J (n=6), sciatica and irradiation with 8 J/cm(2). The right sciatic nerve was exposed and compressed using catgut thread. Five days of treatment were started on the third postoperative day. Pain was assessed by means of the paw elevation time during gait: before sciatica, before and after the first and second therapies, and the end of the fifth therapy. Low-level laser was effective in reducing the painful condition.
Arq Neuropsiquiatr 2011 69(2B) 356-9
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de Souza da Fonseca A, Presta GA, Geller M, de Paoli F, Valenca SS
Departamento de Ciencias Fisiologicas, Instituto Biomedico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro, 20211040, Brazil, adnfonseca@ig.com.br.
Low-intensity laser therapy is based on the excitation of endogenous chromophores in biotissues and free-radical generation could be involved in its biological effects. In this work, the effects of the low-intensity infrared laser on plasma protein content and oxidative stress in blood from Wistar rats were studied. Blood samples from Wistar rats were exposed to low-intensity infrared laser in continuous wave and pulsed-emission modes at different fluencies. Plasma protein content and two oxidative stress markers (thiobarbituric acid-reactive species formation and myeloperoxidase activity) were carried out to assess the effects of laser irradiation on blood samples. Low-intensity infrared laser exposure increases plasma protein content, induces lipid peroxidation, and increases myeloperoxidase activity in a dose- and frequency-dependent way in blood samples. The low-intensity infrared laser increases plasma protein content and oxidative stress in blood samples, suggesting that laser therapy protocols should take into account fluencies, frequencies, and wavelengths of the laser before beginning treatment.
Lasers Med Sci 2011 Jun 24
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Soyer T, Aliefendioglu D, Aktuna Z, Caglayan O, Aydos TR, Cakmak M
Department of Pediatric Surgery, Medical Faculty, Kirikkale University, 71100, Kirikkale, Turkey, soyer.tutku@gmail.com.
AIM: To evaluate the effect of phototherapy on gastrointestinal smooth muscle activity and oxidative stress. METHODS: Wistar albino rats (n = 18, in the first 7 days of life) weighing 7 +/- 2 g with both sexes were included in the study. The animals were randomized into three groups. In control group (CG), median laparotomy was performed to obtain 1 cm of jejunum, terminal ileum and colonic segments. In the phototherapy group (PTG), led phototherapy with a wave density of 40 muw/cm(2)/nm were used (Bilitron 3006, Fanem, Brasil). The efficacy surface of phototherapy was 30-40 cm and the exposure distance was 30 cm. The duration of phototherapy was 24 h. Sham group (SG) received white light with the same wave density and exposure distance. The oxidative stress markers and contraction responses were investigated from intestinal segments obtained from experiments. RESULTS: The jejunum segments showed significantly lowered contraction response to carbachol in SG when compared to CG and PTG (p < 0.05). Decreased contractile response to KCl was detected in both SG and PTG in terminal ileum segments. MDA levels showed no difference between groups (p > 0.05). Total sulfhydryl (T-SH) levels were found significantly increased in PTG when compared to CG and SG (p < 0.05). When NO levels were evaluated, NO levels were found decreased in PTG and SG with respect to CG (p < 0.05). CONCLUSION: PT may cause various alterations in oxidant/antioxidant system in intestinal segments. Unlike to clinical findings, decreased contractile responses were detected in rat gastrointestinal smooth muscles after PT.
Pediatr Surg Int 2011 Jun 1
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Cannon M, Wagner C, Thobaben JZ, Jurado R, Solt D
Northwestern University, Children’s Medical Center, Chicago USA. cannon.m@comcast.net
OBJECTIVES: The purpose of this study was to compare the effectiveness of an antibacterial and hemostatic agent to diode laser irradiation in the healing of mechanically exposed porcine pulps. MATERIALS AND METHOD: The experiment required three adult swine (Sus scrofa domestica, Yorkshire) with 36 teeth prepared with occlusal penetrations into the pulpal tissues. The preparations were performed under general anesthesia and the pulps were exposed using high speed instrumentation with rubber dam isolation and a disinfected field. Following instrumentation the coronal pulpal tissue was amputated and immediately treated with ferric sulfate and chlorhexidine semi-gel (12), diluted Buckley’ formocresol solution (12) for 5 minutes or laser irradiation with a diode laser (12). After treatment, hemostasis was obtained and a ZOE base applied to the treated pulps (36). The pulpal bases were all covered with a RMGI (Fuji II LC). The tissue samples were collected at 4 weeks (28 days). Following fixation, the samples were de-mineralized, sectioned, stained and histologically graded with a scale of 0-4. RESULTS: The treatment groups were statistically different with the Laser Treated Group demonstrating the least inflammation. CONCLUSION: Pulpotomy treatment with the KaVo Gentle Ray Diode Laser demonstrated significantly less inflammation than the other two pulpal therapy modalities. The ferric sulfate and chlorhexidine mixture demonstrated the greatest inflammation as histologically graded. Also, the histological sections of pulpotomized swine teeth treated with the ferric sulfate and chlorhexidine mixture presented with black pigmented areas in the pulp and surrounding tissue. The formocresol group (clinical standard) and the diode laser group did not present with the black precipitate.
J Clin Pediatr Dent 2011 Spring 35(3) 271-6
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Vrijman C, van Drooge AM, Limpens CE, Bos JD, van der Veen JP, Spuls PI, Wolkerstorfer A
Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Centre, University of Amsterdam, NL-1105AZ, Amsterdam, the Netherlands Department of Dermatology, Academic Medical Centre, University of Amsterdam, NL-1100DD, Amsterdam, the Netherlands Medical Library, Academic Medical Centre, University of Amsterdam, NL-1100DD, Amsterdam, the Netherlands. Dutch Cochrane Centre, Academic Medical Centre, NL-1100DD, Amsterdam, the Netherlands. The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), NL-1006BE, Amsterdam, the Netherlands.
Hypertrophic scars are difficult to improve and remain a therapeutic challenge. Several lasers and light sources were evaluated in the past decades and showed to improve hypertrophic scars. However, a systematic review is not available. To assess current evidence of efficacy of all laser and intense pulsed light therapies used in the treatment of hypertrophic scars, we performed a systematic review searching electronic databases MEDLINE, EMBASE and CENTRAL. The quality of the controlled clinical trials was evaluated according to the Cochrane Collaboration’s tool for assessing risk of bias. Thirteen articles involving seven different lasers met the inclusion criteria. Most evidence was found for the pulsed dye laser (PDL) 585 nm (8 studies), followed by the PDL 595 nm (2 studies), whereas limited evidence (one trial per laser) was available for fractional non-ablative laser 1540 nm, CO2 laser 10,600 nm, low level laser therapy (LLLT), Nd:YAG laser 532 nm and ErbiumYAG laser 2940 nm. Treatment recommendations should be formulated with caution as current evidence is insufficient for comparing the efficacy of different laser therapies. The PDL 585 nm showed a low efficacy for the treatment of hypertrophic scars. With moderate efficacy, the PDL 595 nm is promising, although more research is necessary. For the efficacy of other lasers, little evidence was found. Future research, with low risk of bias, well defined scar characteristics, validated outcome measures, standardized measure methods, follow up periods of at least 6 months and well defined laser settings, is needed.
Br J Dermatol 2011 Jun 28
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Demirtas-Tatlidede A, Vahabzadeh-Hagh AM, Bernabeu M, Tormos JM, Pascual-Leone A
Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (Drs Demirtas-Tatlidede and Pascual-Leone and Mr Vahabzadeh-Hagh); Guttmann University Institute for Neurorehabilitation, Universitat Autonoma de Barcelona, Badalona, Spain (Drs Bernabeu, Tormos, and Pascual-Leone).
OBJECTIVE:: To review novel techniques of noninvasive brain stimulation (NBS), which may have value in assessment and treatment of traumatic brain injury (TBI). METHODS:: Review of the following techniques: transcranial magnetic stimulation, transcranial direct current stimulation, low-level laser therapy, and transcranial Doppler sonography. Furthermore, we provide a brief overview of TMS studies to date. MAIN FINDINGS:: We describe the rationale for the use of these techniques in TBI, discuss their possible mechanisms of action, and raise a number of considerations relevant to translation of these methods to clinical use. Depending on the stimulation parameters, NBS may enable suppression of the acute glutamatergic hyperexcitability following TBI and/or counter the excessive GABAergic effects in the subacute stage. In the chronic stage, brain stimulation coupled to rehabilitation may enhance behavioral recovery, learning of new skills, and cortical plasticity. Correlative animal models and comprehensive safety trials seem critical to establish the use of these modalities in TBI. CONCLUSIONS:: Different forms of NBS techniques harbor the promise of diagnostic and therapeutic utility, particularly to guide processes of cortical reorganization and enable functional restoration in TBI. Future lines of safety research and well-designed clinical trials in TBI are warranted to determine the capability of NBS to promote recovery and minimize disability.
J Head Trauma Rehabil 2011 Jun 17
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This month we have 25 new Low Level Laser Therapy papers for your review including: Laser and exercise for subacromial impingement syndrome, yet more on radiotherapy-induced oral mucositis (when will the oncologists catch on?) and a study on how LLLT affects differentiation (and proliferation) of human bone marrow mesenchymal stem cells into neurons and osteoblasts.
Not all LLLT research is a success as a paper on third molar extraction below shows. Suitable wavelength, power density, treatment time, pulses (?), locations and treatment intervals are essential for success. Wouldn’t it be wonderful if there was somewhere you could learn about LLLT parameters? Good news! There are training courses you can attend all over the world (almost) look here. Today I am in Australia having delivered courses in Sydney and Melbourne, last week I was in Washington DC and Atalanta GA (USA). Next week I will be in Boston MA and Chicago IL (USA) then next month in Leeds (UK), Toronto (Canada) and Philadelphia. Click here to find your nearest training course.
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.
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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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21 new papers for you to review this month. No blockbuster news, however there are some items of interest for the LLLT nerds: A clinical trial where laser beats SaliCept and alvogyl in the treatment of alveolar osteitis (a dry socket), an ex-vivo study on protein expression in the synovial membrane taken from patients with rheumatoid arthritis and the neuroprotective effects of LLLT in a light-induced photoreceptor degeneration study (in rats).
Comparison of Alvogyl, SaliCept Patch, and Low-Level Laser Therapy in the Management of Alveolar Osteitis.
Kaya, GS, Yapici, G, Savas Z, Gungormus M
Assistant Professor, Department of Oral and Maxillofacial Surgery, Ataturk University, Faculty of Dentistry, Erzurum, Turkey.
PURPOSE:: The aim of the present randomized prospective clinical trial was to compare the effects of alvogyl, the SaliCept patch, and low-level laser therapy in the management of alveolar osteitis. PATIENTS AND METHODS:: The study population included 104 patients who had been referred to our clinic with a complaint of alveolar osteitis. The patients were randomly assigned to 1 of 4 groups: group 1, curettage and irrigation alone; group 2, curettage and irrigation followed by alvogyl applied directly to the socket; group 3, curettage and irrigation followed by a SaliCept patch applied directly to the socket; and group 4, curettage and irrigation followed by continuous-mode diode laser irradiation (808 nm, 100 mW, 60 seconds, 7.64 J/cm(2)). The treatment procedures were repeated after 3 days. The clinical signs and symptoms for each patient were recorded at diagnosis, at 3 days after the diagnosis, and at 7 days after the diagnosis. In addition, the pain intensity levels for each patient were recorded at diagnosis and daily for 7 days after the initial treatment. RESULTS:: No statistically significant differences in the management of alveolar osteitis were observed between groups 2 and 3. However, the management of alveolar osteitis was significantly better in group 4 than in the other 3 groups. CONCLUSION:: Within the limitations of the present study, it can be concluded that acemannan in the form of the SaliCept patch is an acceptable alternative to alvogyl as a dressing for the management of alveolar osteitis. However, low-level laser therapy treatment at 7.64 J/cm(2) (0.1 W x 60 seconds = 6 J) performed superiorly to both SaliCept and alvogyl in managing alveolar osteitis in our study population.
J Oral Maxillofac Surg 2011 Mar 11
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Balint G, Barabas K, Zeitler Z, Bakos J, Kekesi KA, Pethes A, Nagy E, Lakatos T, Balint PV, Szekanecz Z
National Institute of Rheumatology and Physiotherapy, Frankel Leo Strasse 25-29, Budapest H-1023, Hungary.
Background Soft-laser therapy has been used to treat rheumatic diseases for decades. The major effects of laser treatment may be dependent not on thermal mechanisms but rather on cellular, photochemical mechanisms. However, the exact cellular and molecular mechanisms of action have not been elucidated. Objective The aim of this study was to investigate the ex vivo effects of low-level laser treatment (with physical parameters similar to those applied previously) on protein expression in the synovial membrane in rheumatoid arthritis (RA). Design Synovial tissues were laser irradiated, and protein expression was analyzed. METHODS:/b> Synovial membrane samples obtained from 5 people who had RA and were undergoing knee surgery were irradiated with a near-infrared diode laser at a dose of 25 J/cm(2) (a dose used in clinical practice). Untreated synovial membrane samples obtained from the same people served as controls. Synovial protein expression was assessed with 2-dimensional polyacrylamide gel electrophoresis followed by mass spectrometry. RESULTS: /b> The expression of 12 proteins after laser irradiation was different from that in untreated controls. Laser treatment resulted in the decreased expression of alpha-enolase in 2 samples and of vimentin and precursors of haptoglobin and complement component 3 in 4 samples. The expression of other proteins, including 70-kDa heat shock protein, 96-kDa heat shock protein, lumican, osteoglycin, and ferritin, increased after laser therapy. Limitations The relatively small sample size was a limitation of the study. CONCLUSIONS:/b> Laser irradiation (with physical parameters similar to those used previously) resulted in decreases in both alpha-enolase and vimentin expression in the synovial membrane in RA. Both proteins have been considered to be important autoantigens that are readily citrullinated and drive autoimmunity in RA. Other proteins that are expressed differently also may be implicated in the pathogenesis of RA. Our results raise the possibility that low-level laser treatment of joints affected with RA may be effective, at least in part, by suppressing the expression of autoantigens. Further studies are needed.
Phys Ther 2011 Mar 24
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Okhovat A, Berjis N, Okhovat H, Malekpour A, Abtahi H
Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
BACKGROUND: Despite the high prevalence and morbidity, tinnitus still remains an obscure symptom. We assessed the efficacy of low-level laser for treatment of tinnitus. METHODS: It was a self controlled clinical trial study on 61 outpatients with subjective tinnitus. The patients were irradiated with a 650-nm, 5-mW soft laser for twenty days and twenty minutes per day. The sensation of tinnitus was measured on a Visual Analog Scale (VAS) before and two weeks after treatment and they were compared by means of Wilcoxon signed ranktest. RESULTS: Thirty-eight (62.3%) patients were men and twenty-three (37.7%) were women. Fourteen patients (31.8%) worked in noisy environment. The VAS mean difference before and after the treatment was statistically significant (p < 0.0001). The best treatment effect was in the youngest group and there were significant differences between this group and the middle age and older groups (p = 0.018 and 0.001, respectively). The mean VAS score reduction was not statistically significant between male and female patients (p = 0.23). Also, the treatment outcome according to the noise level in patient’s workplaces was not significantly different in women (p = 0.693), but it was significant in men (p = 0.029). CONCLUSIONS: Transmeatal low-level laser irradiation is effective for the treatment of tinnitus and some variables like age and job can affect the treatment outcome.
J Res Med Sci 2011 Jan 16(1) 33-8
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Albarracin R, Eells J, Valter K
Research School of Biology.
Purpose. We tested the hypothesis that near-infrared (NIR) light treatment (photobiomodulation) would attenuate bright light damage in the albino rat retina. Methods. Young adult Sprague-Dawley (SD) albino rats were raised in dim (5lx) cyclic light then exposed to bright (1000lx) continuous light for 24h. Animals were treated with 670nm light (9J/cm(2)) using an LED array before, during or after light exposure. Retinas were examined for function, structural changes, cell loss, and markers of stress and inflammation at 1week and 1month after exposure to damaging white light. Results. Bright light caused photoreceptor-specific cell death in control retinas. Significant up-regulation of stress and neuroprotective factors, and the presence of activated microglia was also noted following light damage. Photobiomodulation profoundly attenuated histopathological alterations in all three treatment groups. NIR treatment also abolished microglial invasion of the retina and significantly reduced the presence of stress and neuroprotectant molecules. Bright light-induced reductions in photoreceptor function were significantly ameliorated by photobiomodulation in animals treated before and during light damage. Photoreceptor function was initially reduced in animals treated following bright light damage but recovered by one-month post exposure. Conclusions. NIR photobiomodulation is protective against bright light-induced retinal degeneration even when NIR treatment is applied after light exposure. This protective effect appears to involve a reduction of cell death and inflammation. Photobiomodulation has the potential to become an important treatment modality to prevent or treat light-induced stress in the retina. More generally, it could be beneficial in the prevention and treatment of retinal conditions involving inflammatory mechanisms.
Invest Ophthalmol Vis Sci 2011 Mar 18
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Shen CC, Yang, YC, Liu, BS
Department of Neurosurgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
This study used a biodegradable composite containing genipin-cross-linked gelatin annexed with beta-tricalcium phosphate ceramic particles (genipin-gelatin-tricalcium phosphate, GGT), developed in a previous study, as a nerve guide conduit. The aim of this study was to analyse the influence of a large-area irradiated aluminium-gallium-indium phosphide (AlGaInP) diode laser (660nm) on the neural regeneration of the transected sciatic nerve after bridging the GGT nerve guide conduit in rats. The animals were divided into two groups: group 1 comprised sham-irradiated controls and group 2 rats underwent low-level laser (LLL) therapy. A compact multi-cluster laser system with 20 AlGaInP laser diodes (output power, 50mW) was applied transcutaneously to the injured peripheral nerve immediately after closing the wound, which was repeated daily for 5min for 21 consecutive days. Eight weeks after implantation, walking track analysis showed a significantly higher sciatic function index (SFI) score (P<0.05) and better toe spreading development in the laser-treated group than in the sham-irradiated control group. For electrophysiological measurement, both the mean peak amplitude and nerve conduction velocity of compound muscle action potentials (CMAPs) were higher in the laser-treated group than in the sham-irradiated group. The two groups were found to be significantly different during the experimental period (P<0.005). Histomorphometric assessments revealed that the qualitative observation and quantitative analysis of the regenerated nerve tissue in the laser-treated group were superior to those of the sham-irradiated group. Thus, the motor functional, electrophysiologic and histomorphometric assessments demonstrate that LLL therapy can accelerate neural repair of the corresponding transected peripheral nerve after bridging the GGT nerve guide conduit in rats.
Injury 2011 Mar 10
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Ziganshina LE, Eisenhut M
Kazan State Medical Academy, Kazan, Russia.
INTRODUCTION: About one third of the world’s population has latent tuberculosis. In 2004, more than 14 million people had active tuberculosis. About 1.7 million people died from the infection in 2006. More than 80% of new cases diagnosed in 2004 were in people in Africa, South-East Asia, and Western Pacific regions. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing tuberculosis? What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing multidrug-resistant tuberculosis? What are the effects of different drug regimens in people with newly diagnosed pulmonary tuberculosis without HIV infection? What are the effects of different drug regimens in people with multidrug-resistant tuberculosis without HIV infection? What are the effects of low-level laser therapy in people with tuberculosis without HIV infection? Which interventions improve adherence to treatment in people with tuberculosis without HIV infection? 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 32 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: adding pyrazinamide in chemotherapy regimens lasting up to 6 months, adding rifampicin to isoniazid regimens, benefits of different regimens, chemotherapy for <6 months, daily chemotherapy, direct observation treatment, intermittent chemotherapy for 6 months or longer, isoniazid, low-level laser therapy for pulmonary tuberculosis, regimens containing quinolones, rifampicin plus isoniazid, substituting rifampicin with ethambutol in the continuous phase, and support mechanisms for directly observed treatment.
Clin Evid (Online) 2011 2011
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Elm CM, Wallander ID, Endrizzi B, Zelickson BD
Zel Skin & Laser Specialists, 4100 West 50th Street, Edina, Minnesota 55424.
BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been shown to induce cellular reactions in nonphotosynthetic cells however skepticism remains regarding efficacy at the clinical level. The purpose of this study was to evaluate the efficacy of LLLT independent of liposuction. Additionally, a weight loss supplement (Curva, Santa Barbra Medical Innovations, Santa Barbra, CA) was evaluated. This clinical trial evaluates the effectiveness of the Erchonia EML Laser (Zerona System, Santa Barbra Medical Innovations) for non-invasive fat reduction and body contouring in a split-body clinical evaluation. MATERIALS AND METHODS: Five subjects were enrolled and completed the study. Subjects had a body mass index (BMI) of less than or equal to 29 kg/m(2) and satisfied the set inclusion criteria. Participants were randomly assigned to receive low-level laser treatments on one side of the body three times per week for 2 weeks. One group took the weight loss supplement and was also treated with the laser. Subject satisfaction questionnaires, physician blinded photo evaluation, circumference measurements and ultrasound measurements were utilized to evaluate efficacy. RESULTS: Circumference measurements revealed no statistically significant reduction at either 7 days or 1 month post-treatment. One month following treatment the greatest circumference reduction overall was 0.5 +/- 0.3 inches. Ultrasound measurements also did not reveal statistically significant reduction in fat layer thickness (P > 0.5). Evaluation by three blinded dermatologists resulted in average correct photo identification of 51.1%. Results reflect little clinical difference between post-treatment and baseline images. Three subjects recording a “dissatisfied” rating on satisfaction questionnaires and all subjects reported the effects of the treatment were less than expected. Subjects who took the weight loss supplement had no greater circumference reduction or identifiable clinical outcome. CONCLUSIONS: This small study demonstrates to the authors that there needs to be more evidence to show clinical circumferential reduction before LLLT can be recommended as an effective therapeutic option.
Lasers Surg Med 2011 Feb 43(2) 114-21
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Lapchenko AS, Kucherov AG, Levina IV, Ivanets IV, Krasiuk AA, Kadymova MI
NOTs patologii verkhnikh dykhatel’nykh putei, ukha i neotlozhnoi otorinolaringologii RGMU, Moskva.
A total of 165 patients presenting with neurosensory impairement of hearing and Meniere’s disease were treated by supravascular (extracorporeal) laser irradiation of blood. The study undertaken to evaluate the efficacy of this treatment confirmed its beneficial effect in patients with acute hearing disorders. It was equally effective as regards elimination of labyrinthine hydropsis in patients presenting with Meniere’s disease. The method proved less efficacious for the management of long-standing hearing impairement and chronic loss of hearing, but it can be used to prevent the development of these conditions.
Vestn Otorinolaringol 2011 (1) 39-40
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de Villiers JA, Houreld NN, Abrahamse H
Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein, 2028, South Africa.
INTRODUCTION: Human adipose derived stem cells (hADSCs), with their impressive differentiation potential, may be used in autologous cell therapy or grafting to replace damaged tissues. Low intensity laser irradiation (LILI) has been shown to influence the behaviour of various cells, including stem cells. AIMS: This study aimed to investigate the effect of LILI on hADSCs 24, 48 or 72 h post-irradiation and their differentiation potential into smooth muscle cells (SMCs). METHODOLOGY: hADSCs were exposed to a 636 nm diode laser at a fluence of 5 J/cm(2). hADSCs were differentiated into SMCs using retinoic acid (RA). Morphology was assessed by inverted light and differential interference contrast (DIC) microscopy. Proliferation and viability of hADSCs was assessed by optical density (OD), Trypan blue staining and adenosine triphosphate (ATP) luminescence. Expression of stem cell markers, beta1-integrin and Thy-1, and SMC markers, smooth muscle alpha actin (SM-alphaa), desmin, smooth muscle myosin heavy chain (SM-MHC) and smoothelin, was assessed by immunofluorescent staining and real-time reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Morphologically, hADSCs did not show any differences and there was an increase in viability and proliferation post-irradiation. Immunofluorescent staining showed expression of beta1-integrin and Thy-1 72 h post-irradiation. RT-PCR results showed a down regulation of Thy-1 48 h post-irradiation. Differentiated SMCs were confirmed by morphology and expression of SMC markers. CONCLUSION: LILI at a wavelength of 636 nm and a fluence of 5 J/cm(2) does not induce differentiation of isolated hADSCs over a 72 h period, and increases cellular viability and proliferation. hADSCs can be differentiated into SMCs within 14 days using RA.
Stem Cell Rev 2011 Mar 5
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Calis HT, Berberoglu N, Calis M
Kayseri Education and Research Hospital, Physical Therapy and Rehabilitation Clinic, Kayseri, Turkey – mcalis@erciyes.edu.tr.
BACKGROUND: Subacromial impingement syndrome (SIS) is the most common reason for shoulder pain. Ultrasound and laser are the physical therapy modalities, in conservative treatment of SIS. AIM: The aim of this study was to define and compare the efficacy of ultrasound, laser and exercise in the treatment of SIS. DESIGN: This was a randomized controlled trial with-pre and post-treatment evaluations SETTING: Out-patients referred to physical medicine and rehabilitation unit. POPULATION: This study was performed on 52 patients with SIS. The patients were randomly allocated into three groups METHODS: The patients were treated five days a week for three weeks with hotpack+ultrasound+exercise (the first group); hotpack+laser+exercise (the second group), or hotpack+exercise (the third group). The pre and post treatment ranges of motion were measured in the patients. The visual analogue scale (VAS) was used to evaluate the severity of pain. Constant scoring was used to evaluate the shoulder functions and the results were compared after the treatment. RESULTS: When the post-treatment results of the groups were compared with the pretreatment results, there was a statistically significant improvement in each of the three groups, in the pain, the range of motion and the functional improvement at the shoulder (P<0.05). However, the inter-group comparison did not reveal any statistically significant difference in the parameters indicating improvement (P>0.05). CONCLUSION: The results of this study demonstrated that ultrasound and laser treatments were not superior to each other in the treatment of SIS. Clinical Rehabilitation Impact. Exercise treatment forms the base for the conservative treatment.
Eur J Phys Rehabil Med 2011 Mar 2
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Choi MS, Yun SJ, Beom HJ, Park HR, Lee JB
Department of Dermatology, Chonnam National University Medical School, Gwangju Department of Dermatologic Beauty, Cheongam University, Suncheon Department of Chemistry, Chonnam National University, Gwangju, Korea.
Propionibacterium acnes naturally produces endogenous porphyrins that are composed of coproporphyrin III (CPIII) and protoporphyrin IX (PpIX). Red light alone and photodynamic therapy (PDT) improve acne vulgaris clinically, but there remains a paucity of quantitative data that directly examine the bactericidal effects that result from PDT on P. acnes itself in vitro. The purpose of this study was to measure the difference of bactericidal effects of 5-aminolevulinic acid (ALA)-PDT with red and blue light on P. acnes. P. acnes were cultured under anaerobic conditions and divided into two groups (ALA-treated group and control group), and were then illuminated with blue (415 nm) and red (635 nm) lights using a light-emitting diode (LED). The cultured P. acnes were killed with both blue and red LED light illumination. The efficacy increased with larger doses of light and a greater number of consecutive illuminations. We demonstrated that red light phototherapy was less effective for the eradication of P. acnes than blue light phototherapy without the addition of ALA. However, pretreatment with ALA could enhance markedly the efficacy of red light phototherapy.
J Dermatol 2010 Nov 3
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Melo VA, Anjos DC, Albuquerque Junior R, Melo DB, Carvalho FU
Department of Experimental Surgical, Federal University of Sergipe, Aracaju, SE, Brazil.
PURPOSE: To evaluate the effect of low-level laser therapy (LLLT) e904 nm on healing of surgical wounds in rats. METHODS: Forty male Wistar rats were used, divided into four groups, underwent incision along the lines Alba covering skin, subcutaneous and muscle abdominal, sutured continuously for nylon 5-0. Eight and fifteen days after the surgery process, the repairing area was removed and histological sections were stained with hematoxylin-eosin to assess cellularity inflammatory, Masson’s Trichrome and Picrossirus to quantify the collagen fibers and immunohistochemical technique for counting newly formed vessels. The data were compared statistically using analysis of variance ANOVA, with a “post-hoc Tukey test, p <0.05. RESULTS: Low-level laser therapy reduced the intensity of the inflammatory reaction and influenced the dynamic of the immunoinflammatory response by inducing switching of the leukocyte infiltration pattern (neutrophilic to lymphoplasmacytic infiltration). Also stimulate the deposition and enhance the organization of collagen fibers, featuring a delicate collagen type III. Furthermore, it appeared to a significant increase in the average number of newly formed vessels (p = 0.00 and p = 0.02, respectively). CONCLUSION: Low-level laser therapy resulted in modulate of the inflammatory response, enhanced deposition of collagen fibers and increase in the average number of newly formed vessels.
Acta Cir Bras 2011 Apr 26(2) 129-34
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Bergamaschi M, Ferrari G, Gallamini M, Scoppa F
First Faculty of Medicine and Surgery, Sapienza University, Rome, Italy.
The risk of falling is rather high among elderly people. Indexes obtained through the Romberg stabilometric test on a force platform have been suggested to be correlated with the risk of falling. This work aimed to test the effectiveness of auriculopuncture and ultralow-power laserpuncture versus placebo (sham stimulation) in improving postural control in an elderly population. Balance performance was measured on a force platform before and after both forms of stimulation. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. Although the sample size does not allow reliable statistical analysis, the modifications are remarkable and some differences are observed between the two kinds of stimulation. Further testing with larger sized groups and including one further group using both stimulations is suggested. Although postural instability has to be defined as multi-factorial, it is often associated with balance dysfunctions that cannot be related to vestibular or central impairments but rather to proprioceptive deficits. A significant role may be ascribed to (even subliminal) nociceptive interferences with proprioceptive inputs and to a reduced capacity for updating cortical motor control models in the case of progressively declining locomotor capabilities. The explanation tentatively put forward to account for the results observed in the present preliminary study is that laser acupuncture and auriculopuncture stimulations reduce nociceptive interference and thus improve postural control.
J Acupunct Meridian Stud 2011 Mar 4(1) 69-74
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Wang L, Huang T, Zhang W, Litscher G
Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Graz, Austria.
Laser Doppler flowmetry for microcirculation monitoring was performed in 10 healthy volunteers (mean age +/- SD: 24.9 +/- 3.3 years; 5 females, 5 males) prior to, during, and after stimulation using a noninvasive violet (405 nm) laser needle at the Dazhui (GV14) acupoint. The results of this controlled study (control point at the shoulder) showed significant (p < 0.05) increases in Flux (product of concentration and velocity of erythrocytes) at a distance of 3 cm from the acupoint. At the same time, no changes were found at the control point. Furthermore, 5 minutes after stimulation the microcirculation still flowed at a higher level than baseline values at the beginning of the investigation. In a single individual it was demonstrated that needle acupuncture enhanced this effect and placebo (deactivated laser) did not have a significant effect. The results suggest that violet laser acupuncture at the acupoint Dazhui can increase vascular effects on microcirculation.
J Acupunct Meridian Stud 2011 Mar 4(1) 24-8
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Silva MP, Bortone F, Silva MP, Araujo TR, Costa MS, Silva Junior JA
Universidade Nove de Julho, Sao Paulo, SP, Brazil.
BACKGROND: Low level laser therapy (LLLT) has been used clinically in order to treat inflammation, where tissue and plasma prekallikrein have crucial importance. Plasma prekallikrein (PPK) is synthesized by the hepatocytes and secreted into the bloodstream, where it participates in the surface-dependent activation of blood coagulation, fibrinolysis, kinin generation and inflammation. Tissue prekallikrein is associated with important disease states (including cancer, inflammation, and neurodegeneration) and has been utilized or proposed as clinically important biomarker or therapeutic target of interest. OBJECTIVE: To evaluate if LLLT modulates tissue and plasma prekallikreins mRNA expression in the carrageenan-induced rat paw edema. METHODS: Experimental groups were assigned as followed: A1 (Control-saline), A2 (Carrageenan-only), A3 (laser 660nm only) and A4 (Carrageenan + laser 660nm). Edema was measured by a plethysmometer. Subplantar tissue was collected for the quantification of prekallikreins mRNA by Real time-Polymerase Chain Reaction. RESULTS: A significantly decrease in the edema was observed after laser irradiation. Expression of prekallikreins increased after carrageenan injection. Tissue and plasma prekallikrein mRNA expression significantly decreased after LLLT’s 660nm wavelength. CONCLUSION: These results suggest that expression of tissue and plasma prekallikreins is modulated by LLLT, which can be used in clinical practice due to its anti-inflammatory effects.
Rev Bras Fisioter 2011 Mar 18
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Kim RH, Armstrong AW
University of California, Davis, School of Medicine, Sacramento, California. aprilarmstrong@post.harvard.edu.
Acne vulgaris continues to be a challenge to dermatologists and primary care physicians alike. The available treatments reflect the complex and multifactorial contributors to acne pathogenesis, with topical retinoids as first-line therapy for mild acne, topical retinoids in combination with anti-microbials for moderate acne, and isotretinoin for severe nodular acne. Unfortunately, these conventional therapies may not be effective against refractory acne, can lead to antibiotic resistance, and is associated with adverse effects. With the rise of new technologies and in-office procedures, light and laser therapy, photodynamic therapy, chemical peels, and comedo extraction are growing in popularity as adjunctive treatments and may offer alternatives to those who desire better efficacy, quicker onset of action, improved safety profile, reduced risk of antibiotic resistance, and non-systemic administration. Whereas adjunctive therapies are generally well-tolerated, the number of randomized controlled trials are few and limited by small sample sizes. Furthermore, results demonstrating efficacy of certain light therapies are mixed and studies involving photodynamic therapy and chemical peels have yet to standardize and optimize application, formulation, and exposure times. Nevertheless, adjunctive therapies, particularly blue light and photodynamic therapy, show promise as these treatments also target factors of acne pathogenesis and may potentially complement current conventional therapy.
Dermatol Online J 2011 17(3) 2
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Karaman MI, Koca O, Kucuk EV, Ozturk M, Gunes M, Kaya C
Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
PURPOSE: Monosymptomatic nocturnal enuresis is the nighttime bed-wetting that occurs among children without lower urinary tract symptoms or bladder dysfunction, and affects a considerable part of the population. In our study the effect of laser acupuncture therapy on patients with primary monosymptomatic nocturnal enuresis was evaluated in a prospective, randomized, placebo controlled, single-blind study. MATERIALS AND METHODS: A total of 91 children with a mean age of 8.6 years who presented to our outpatient clinic with primary monosymptomatic nocturnal enuresis and had not received any medical therapy were included in the study. The children were randomized into 2 groups. In group 1 laser acupuncture was performed 3 times a week for 4 weeks, whereas the same program via a nonlaser light to the same points was performed on the children in group 2 (placebo group). The number of weekly bed-wetting episodes before therapy was recorded, and the children were reevaluated 15, 30, 90 and 180 days after treatment. RESULTS: The mean number of bed-wetting episodes was 1.7 per week 6 months after laser therapy. In the placebo group the mean number of weekly bed-wetting episodes was 3.1. Laser acupuncture therapy was significantly more beneficial compared to placebo in terms of complete dryness, partial improvement and a decrease in the mean number of weekly bed-wetting episodes. CONCLUSIONS: Laser acupuncture therapy, a noninvasive, painless, short-term therapy with a low cost, can be considered as an alternative therapy for patients with primary monosymptomatic nocturnal enuresis.
J Urol 2011 Mar 17
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Radvanska E, Kamperis K, Kleif A, Kovacs L, Rittig S
Department of Pediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark; Department of Pediatrics, School of Medicine, Comenius University, Bratislava, Slovakia.
PURPOSE: The alternative treatments for enuresis have been reported with high efficacy but in noncontrolled studies. Therefore, using a prospective, single-blind, randomized, placebo controlled design we evaluated the effect of laser acupuncture on bladder reservoir function and enuresis frequency in cases of monosymptomatic nocturnal enuresis with reduced maximal voided volume. MATERIALS AND METHODS: A total of 31 patients with monosymptomatic nocturnal enuresis, with at least 3 enuretic nights per week and less than 70% of normal age related maximal voided volume without first morning void (Koff’s formula), no constipation, urinary tract abnormalities, or daytime incontinence were randomized into group 1-active laser acupuncture, group 2-placebo treatment with red light and skin contact and group 3-placebo treatment with red light without skin contact. After a 2-week run-in period (when patients made home recordings of nocturnal urinary production and during 2 weekends frequency-volume charts), the patients started a 5-week treatment. During the last 2 weeks of treatment patients performed the same recordings as during the run-in period. RESULTS: We found no significant effect of active laser acupuncture on maximal voided volume (first morning void excluded), maximal morning voided volume, voiding frequency, enuresis frequency before and after treatment or nocturnal urine production among the patient groups. However, we found that laser acupuncture resulted in a significant increase in average daytime voided volume. We found no effect of skin contact during placebo laser acupuncture. CONCLUSIONS: Laser acupuncture is a safe but inefficient treatment for monosymptomatic nocturnal enuresis with reduced maximal voided volume. However, we found subtle effects on bladder reservoir function.
J Urol 2011 Mar 17
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Guo H, Luo Q, Zhang, J, Lin H, Xia L, He C
Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
OBJECTIVE: To study the therapeutic effects that different physical factors may have on rabbits with osteoarthritis of the knee. METHODS: A total of 64 rabbits were randomised and organised into eight groups, eight of which were each assigned a different physical factor, in which the rabbits received one type of physical therapy: millimetre waves for 20min, pulsed electromagnetic fields, millimetre waves for 40min, ultrasound, low-level laser therapy or ultrashort wave diathermy. The two remaining groups, the normal group and the model group, served as controls. The efficacy of the different treatments were determined by observing the configuration and structure of the cartilaginous tissue by haematoxylin and Eosin staining, measuring the serum tumour necrosis factor-alpha levels by enzyme immunoassay, evaluating the expression levels of caspases-3 and -8 by immunohistochemistry, and calculating the ratio of chondrocytes apoptosis by TdT-mediated dUTP nick end labelling. The values obtained for each assessment of the eight groups were analysed by a One-way ANOVA. RESULTS: By applying upmentioned physical treatments, the organisational configuration and structure of cartilage cells from the knees of rabbits with osteoarthritis increased. These treatments also decreased serum tumour necrosis factor-alpha levels, reduced the expression of caspase-3 and caspase-8 and reduced chondrocyte apoptosis, resulting in an overall delay in osteoarthritis development. CONCLUSION: The application of pulsed electromagnetic fields, millimetre waves for 40min, ultrasound, or low-level laser therapy had significant effects in improving osteoarthritis; in particular, treatment with pulsed electromagnetic fields or ultrasound yielded the greatest therapeutic effect.
Joint Bone Spine 2011 Mar 10
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Steffens D, Maher CG
Centre for Evidence-Based Physiotherapy, The George Institute for Global Health, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. dsteffens@georgeinstitute.org.au.
Br J Sports Med 2011 Apr 45(5) 459
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Schwartz-Filho HO, Reimer AC, Marcantonio C, Marcantonio E Jr, Marcantonio RA
Division of Periodontology, Department of Oral Diagnosis and Surgery, School of Dentistry, UNESP, Sao Paulo State University, Araraquara, SP, Brazil, betoschwartz@hotmail.com.
The present in vitro study evaluated parameters of osteogenesis under the influence of low-level laser therapy (LLLT) at different doses. Osteogenic cells originated from rat calvaria were cultivated in polystyrene plates and exposed to a laser irradiation using an indium-gallium-aluminum phosphide therapeutic laser (InGaAIP), at wavelength of 685 nm, power of 35 mW, 600-mum-diameter optical fiber, and continuous wave. In the attempt of observing the existence of a dose response and its effects, laser irradiation was performed at 25, 77, and 130 J/cm(2) (7, 22, and 37 s, respectively). The following parameters were assessed: growth curve (4, 7, and 11 days), cell viability (24 h), and nodular formation of mineralized matrix (14 days). The results did not show significant differences related to the growth curve (4, 7, and 11 days) and cell viability (24 h). Within 14 days, osteogenic cultures showed nodular areas with well-defined calcified matrix. The total area stained with Alizarin Red did not show any differences between doses of 25 and 130 J/cm(2). However, the percentage of stained area was significantly higher in the 25 J/cm(2) group when compared to the group of 77 J/cm(2) (Kruskal-Wallis test, p < 0.05). It was possible to conclude that the 685-nm laser irradiation (at 25, 77, and 130 J/cm(2)) did not influence cell growth and proliferation, although the extracellular mineralization process may have its pattern altered by the LLLT on osteogenic cell cultures.
Lasers Med Sci 2011 Mar 9
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The survey not very specific and just refers to “optical therapeutic devices” and “photonic products” in it’s list of “significantly innovative technology areas likely by 2018”
FDA significantly innovative technology areas likely by 2018
full paper available here http://www.fda.gov/downloads/AboutFDA/CentersOffices/CDRH/CDRHReports/UCM238527.pdf
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