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Nova Possibilidade de Sinergismo em Terapia com Laser de Baixa Intensidade (LBI) Associada ao Anti-Oxidante (N-acetil cisteina) Reduzindo Sintomas Precoces e Tardios em Vias Aéreas sobre a Expressão de Proteína Inflamatória de Macrófago (MIP-2) e Expressão de mRNA com a Geração de Espécies Reativas de Oxigênio (EROs)

27 de Julho de 2010

F. Mafra de Lima1A. Balbin Villaverde2R. Albertini2,A. P. Ligeiro de Oliveira3H. C. Castro-Faria-Neto4*F. Aimbire21 Instituto de Pesquisa e Desenvolvimento, IP&D, UNIVAP, São Josédos Campos, CEP: 12244-000, São Paulo - SP - Brazil.2 Instituto de Engenharia Biomédica - Universidade Camilo Castelo Branco- UNICASTELO, Rodovia Presidente Dutra, Km 138, São José dosCampos, CEP: 12247-004 - São Paulo - SP - Brazil.3 Institute of Biomedical Science, Department of Pharmacology, Av.Prof. Lineu Prestes, 1524, CEP: 05508-900 - São Paulo - SP - Brazil.4 Laboratory of Immunopharmacology, IOC, FIOCRUZ, Po Box 926,CEP: 21045-900 - Rio de Janeiro - RJ - Brazil.Endereço:Flávio Aimbire. Biomedical Engineering Institute. Universidade Camilo Castelo Branco - UNICASTELO, Km 138, Rodovia PresidenteDutra Km 138 - São José dos Campos - CEP: 12247-004 - São Paulo - SP - Brazil. E-mail: flavio.aimbire@unicastelo.brAbstractObjective: The aim of this work was to investigate the LowLevel Laser Therapy (LLLT) effect on alveolar macrophages (AM)activated by oxidative stress and lipopolysaccharide (LPS).Background data: LLLT has been reported to actuate positivelyfor relieving the late and early symptoms of airway and lunginflammation. It is not known if the increased MIP-2 mRNAexpression and intracellular ROS generation observed in acute lunginflammation (ALI) can be influenced by LLLT. Methods: Rat AMcell line, AMJ2-C11 was cultured in a medium with LPS or H2O2and Laser irradiated (ë= 660 nm) at Fluence of 4.5 J/cm2. MIP-2mRNA and ROS production in AM were evaluated by Real Time-PCR and the 2′,7′-dichlorofluorescin diacetate (DCFH-DA),respectively. The NF-êB protein in AM was measured by ELISAResumoObjetivo: O objetivo deste trabalho foi investigar o efeito doLaser de baixa intensidade (LBI) o sobre macrófagos alveolares(MA) ativado pelo estresse oxidativo e lipopolissacarídeo (LPS). Aterapia com LBI tem sido descrita favoravelmente, pois atua aliviandoos sintomas precoces e tardios de inflamação pulmonar nasvias aéreas. Não se sabe se com o aumento de MIP-2 na expressãodo mRNA e geração de ROS intracelulares observados na inflamaçãopulmonar aguda (IPA) podem ser influenciados pelo LBI. Métodos:Rat AM linha celular, AMJ2-C11 foi cultivado em meio comLPS ou H2O2 e sendo irradiado com Laser ( ë= 660 nm) com Fluênciade 4,5 J/cm2. A produção de MIP-2 mRNA e ROS no MA foramavaliados por Real-Time PCR e 2 ‘, 7’-diacetato dichlorofluorescin(DCFH-DA), respectivamente. A NF- êB proteína na PM foi meartigooriginal - 4.pmd 12/4/2010, 09:23 40 

A Terapia com Laser de Baixa Intensidade (LBI) pode Reduzir o Edema Pulmonar, tanto o influxo de Neutrófilos quanto o Nível de IL-1B nas vias Aéreas Pós Inflamação Induzida por LPS no Pulmão

27 de Julho de 2010

F. AimbireA. P. Ligeiro de Oliveira2R. Albertini1J. C. Corrêa3C.B. Ladeira de Campos1J. P. Lyon1J. A. Silva Jr4M. S. Costa11 Instituto de Pesquisa & Desenvolvimento - IP&D, Universidade do Valedo Paraíba - UNIVAP. Av. Shishima Hifumi, 2911, CEP: 12244-000. SãoJosé dos Campos - SP - Brazil.2 Laboratório de Farmacologia das Vias Aéreas e Endócrina, Departamentode Farmacologia, Universidade de São Paulo - USP. Av. Prof. LineuPrestes, 1524, CEP: 05508-900. São Paulo - SP - Brazil.3 Departamento de Fisioterapia, Centro Universitário Nove de JulhoUNINOVE. Rua Vergueiro, 235, São Paulo - SP - Brazil.4 Departamento de Ciências da Reabilitação, Centro Universitário Nove

de Julho UNINOVE. Rua Vergueiro, 235, São Paulo - SP - Brazil.

Abstract                                                                                                                                                                                                                                      Background and Objective: Low level laser therapy (LLLT)is a known anti-inflammatory therapy. Herein we studied the effect ofLLLT on lung permeability and the IL-1â level in LPS-induced pulmonaryinflammation.                                                                                                                                                                                                                                                                                                                                          Study Design/Methodology: Rats were dividedinto 12 groups (n=7 for each group). Lung permeability was measuredby quantifying extravasated albumin concentration in lung homogenate,inflammatory cells influx was determined by myeloperoxidaseactivity, IL-1â in BAL was determined by ELISA and IL-1â mRNAexpression in trachea was evaluated by RT-PCR. The rats were irradiatedon the skin over the upper bronchus at the site of tracheotomy afterLPS.                                                                                                                                                                                                                                                                                                                                                                       Results: LLLT attenuated lung permeability. In addition, therewas reduced neutrophil influx, myeloperoxidase activity and both IL-1âin BAL and IL-1â mRNA expression in trachea obtained from animalssubjected to LPS-induced inflammation.                                                                                                                                                                                                                                                                                                                                                             Conclusion: LLLT reducedthe lung permeability by a mechanism in which the IL-1â seems to havean important role.                                                                                                                                                                                                                                                                                                                                                                         Descriptors: Laser Therapy (LLLT), Inflammation, Lung Permeability,Bronchoalveolar Lavage (BAL), Interleukin-1â (IL-1â), Lipopolysaccharide(LPS)Resumo                                                                                                                                                                                                                                                                                                    O Laser de baixa intensidade (LBI) é conhecido por sua açãoanti-inflamatória. Nós estudamos o efeito da LLLT na permeabilidadepulmonar e da IL-1 â nível em LPS-induced inflamação pulmonar.Os ratos foram divididos em 12 grupos (n = 7 para cada grupo). Apermeabilidade pulmonar foi avaliada através da concentração dealbumina extravasada em homogenado de pulmão e o influxo decélulas inflamatórias foi determinado através da atividade demieloproxidase. A IL-1 no lavado broncoalveolar foi analisada porELISA e na traquéia foi avaliada pelo RT-PCR. Os ratos foram irradiadospor sobre a pele na região do brônquio superior na altura datraqueostomia após instilação de LPS. O LBI atenuou o edema pulmonar,além disso, houve redução da migração de neutrófilos, daatividade de mieloperoxidase, e redução dos níveis de IL-1 â no LBAe na traquéia obtidos de animais submetidos à inflamação induzidapor LPS. LBI reduziu a permeabilidade pulmonar por um mecanismoem que a IL-1 â parece ter um papel importante.                                                                                                                                                                                                                                                                                                                                                                                                                                        Descritores: Laser Terapia (LBI), Inflamação, Permeabilidade Pulmonar,Lavado Broncoalveolar (BAL), Interleucina-1 â (IL-1 â), Lipopolissacarídeo(LPS)artigo original - 3.pmd 12/4/2010, 09:23 30 

 

Efeito do Laser de Baixa Intensidade (LBI) na Inflamação das Vias Aéreas pelo Mecanismo dependente de NF-kB Resultando na Atenuação de Hiperreatividade Brônquica Colinérgica, Hiporreatividade B2-Adrenérgica e na Expressão do mRNA de TNF-x em Modelo Experimental Pulmonar

27 de Julho de 2010

F. Mafra de Lima1M. S. Costa1R. Albertini1J. A. Silva Jr2F. Aimbire11 Institute of Research and Development - IP&D - Av. Shishima Hifumi,2911, Urbanova, 12244-000, São José dos Campos - SP - Brazil.2 Departamento de Ciências da Reabilitação, Centro UniversitárioNove de Julho UNINOVE. Rua Vergueiro, 235 - SP - Brazil.                                                   Abstract                                                                                                                                                                                                                                                                                                                                                                   Background and Objective: It is unknown if the decreasedability to relax airways smooth muscles in asthma and other inflammatorydisorders, such as acute respiratory distress syndrome (ARDS),can be influenced by Low Level Laser Therapy (LLLT) irradiation. Inthis context, the present work was developed in order to investigate ifLLLT could reduce dysfunction in inflamed bronchi smooth muscles(BSM) in rats.                                                                                                                                                                                                                                                                                                                                                                                                             Study Design/Material and Methods: A controlledex-vivo study was developed where bronchi from Wistar rat weredissected and mounted in an organ bath apparatus with or without aTNF-á.                                                                                                                                                                                                                                                                                                                                                                                                                                                         Results: LLLT administered perpendicularly to a point inthe middle of the dissected bronchi with a wavelength (ë) of 655 nm anda dose of 2.6 J/cm2, partially decreased BSM hyperreactivity to cholinergicagonist, restored BSM relaxation to isoproterenol and reducedthe TNF-á mRNA expression. An NF-KB antagonist (BMS205820)blocked the LLLT effect on dysfunction in inflamed bronchi smoothmuscles. Conclusion: The results obtained in this work indicate thatthe LLLT effect on alterations in responsiveness of airway smoothmuscles observed in TNF-á-induced experimental acute lung inflammationseems to be dependent of NF-êB activation.                                                                                                                                                                                                                                                                                                                                                                                                                                                 Descriptors: Low Level Laser Therapy (LLLT); TNF-á; cAMP; NF-êB;Airway Inflammation (Bronchi), Lung                                                                                                       Resumo                                                                                                                                                                                                                                            Não se sabe se a diminuição da capacidade de relaxar os músculoslisos das vias aéreas na asma brônquica e outras doenças inflamatórias,como a síndrome do desconforto respiratório agudo (SARS ou SARA),pode ser influenciada por meio do Laser de Baixa Intensidade (LBI ouLLLT). Neste contexto, o presente trabalho foi desenvolvido, a fim deinvestigar se LLLT poderia reduzir tal disfunção na musculatura lisa dosbrônquios inflamados (DMLBI ou, simplesmente, BSM), em ratos. Umestudo controlado em vivo foi desenvolvido em brônquios de ratos Wistar,que foram dissecados e colocados em um aparelho de banho de órgãos,com ou sem um TNF- á. LLLT administrado usando comprimento deonda ( ë) de 655 nm e dose = 2,6 J/cm2, perpendicularmente, a um pontono meio dos brônquios dissecados. A diminuição da hiperreatividadedos BSM, parcialmente, para agonista colinérgico, foi restaurada pelorelaxamento BSM para isoproterenol e reduziu a expressão do mRNA deTNF- á. O antagonista do NF- êB bloqueou o efeito do LILT sobre adisfunção da musculatura lisa dos brônquios inflamados. Os resultadosobtidos neste trabalho indicam que o efeito terapêutico do LBI, sobrealterações na capacidade de resposta dos músculos lisos das vias aéreas,geralmente, observadas em TNF- á induzida por inflamação pulmonaraguda experimental, parece ser dependente da ativação de NF- êB.                                                                                                                                                                                                                                                                                                                                                                                           Descritores: Terapia com Laser de Baixa Intensidade (LBI), TNF- á,AMPc, NF- êB, Inflamação das Vias Aéreas (Brônquios), Pulmão

Efeito do Laser de Baixa Intensidade (LBI) sobre o Recrutamento de Neutrófilos e a Concentração de Quimiocinas/Citocinas Usando o Lavado Bronco-Alveolar (BAL) na Inflamação Aguda Pulmonar em Modelo Animal

27 de Julho de 2010

pag. 08_0001

F. Mafra de Lima1A. B. Villaverde2M. A. Salgado3H. C. Castro-Faria-Neto4E. Munin2R. Albertini2F. Aimbire21 Institute of Research and Development, UNIVAP, Av. Shishima Hifumi,2911, Urbanova, CEP: 12.244-000, São José dos Campos - SP - Brazil.2 Institute of Biomedical Engineering, UNICASTELO, Km 138, ViaDutra, CEP: 12.247-004, São José dos Campos - SP - Brazil.3 Department of Histology, Faculty of Dentistry, UNESP, Av. Eng. FranciscoJosé Longo, 777, São José dos Campos - SP - Brazil.4 Laboratory of Immunopharmacology, FIOCRUZ, Po Box 926, CEP:21045-900, Rio de Janeiro - RJ - Brazil.                                                              Abstract                                                                                                                                                                                                                                                It has been suggested that low intensity Laser therapy (LILT)acts on pulmonary inflammation. Thus, we investigate in this workif LILT (660 nm) can attenuate edema, neutrophil recruitment andinflammatory mediators in acute lung inflammation. Male Wistarrats were exposed to aerosolized lipopolysaccharide (LPS) and thentreated with LILT. Airway inflammatory was measured 4h postLPS. Pulmonary microvascular leakage was used for measuring ofpulmonary edema. Bronchoalveolar lavage fluid (BAL) cellularityand myeloperoxidase (MPO) were used for measuring of neutrophilrecruitment and activation. RT-PCR was performed in lung tissueto assess mRNA expression of tumor necrosis factor-á (TNF-á),interleukin-1â (IL-1â), interleukin (IL-10), cytokine-inducedneutrophil chemoattractant-1 (CINC-1), macrophage inflammatoryprotein-2 (MIP-2) and intercellular adhesion molecule-1 (ICAM-1). Protein levels both BAL and lung were determined by ELISA.LILT inhibited pulmonary edema and endothelial cytoskeleton      damage, as well as neutrophil influx and activation. Similarly theLILT reduced the TNF-á and IL-1â, in lung and BAL. LILT preventedlung ICAM-1 up-regulation. The rise of CINC-1 and MIP-2protein levels both lung and BAL was unaffected, thus like the lungmRNA expressions for IL-10. Data suggest that the LILT effect isdue to the inhibition of ICAM-1 via the inhibition of TNF-á andIL-1â.                                                                                                                                                                                                                                                                                                                                                                                                                  Descriptors: Pulmonary Inflammation, Neutrophils, InflammatoryMediators, Endothelial Cytoskeleton, Phototherapy, BronchoalveolarLavage (BAL), Laser (LLLT)                                                                                                                                                                      Resumo                                                                                                                                                                                                                                                                                                     Alguns autores sugerem que a terapia com Laser de baixa intensidade(LILT ou LBI em português) age sobre a inflamação pulmonar.Assim, investigamos neste estudo se a LILT (660 nm) podeatenuar o edema, o recrutamento de neutrófilos e a expressão demediadores inflamatórios na inflamação pulmonar aguda. Para tanto,ratos da raça Wistar machos foram expostos ao aerossol delipopolissacarídeo (LPS) e, em seguida, tratados com LILT. A inflamaçãodas vias aéreas foi analisada 4 horas após o LPS. Apermeabilidade vascular foi utilizada como parâmetro de análise doedema pulmonar. O lavado broncoalveolar (BAL) e a mieloperoxidase(MPO) foram utilizados para a avaliação do recrutamento e ativaçãode neutrófilos. O RT-PCR foi realizado no tecido pulmonar paraavaliar a expressão de RNAm para o fator de necrose tumoral- á(TNF- á), as interleucina-1 â (IL-1 â) e interleucina (IL-10), a citocinainduzida quimiotática de neutrófilos-1 (CINC - 1), a proteína inflamatóriade macrófago-2 (MIP-2) e a molécula de adesão intercelular (ICAM-1). Os níveis de proteína no BAL e no pulmão foram determinadospor ELISA. LILT inibiu o edema pulmonar e o dano aocitoesqueleto endotelial, bem como o influxo e ativação de neutrófilos.Do mesmo modo, a TLBI reduziu o TNF- á e a IL-1 â, no pulmão e noLBA. LILT atenuou o aumento da expressão de ICAM-1 no pulmão.O aumento dos níveis protéicos de CINC-1 e MIP-2 tanto pulmãoquanto no BAL não foram alterados pelo LILT, assim como a expressãode IL-10 no pulmão. Os resultados sugerem que o efeito LILT édevido à inibição da ICAM-1 através da inibição do TNF- á e IL-1 â.                                                                                                                                                                                                                                                                                                                                                                            Descritores: Inflamação Pulmonar, Neutrófilos, Mediadores Inflamatórios,Citoesqueleto Endotelial, Fototerapia, Lavado Broncoalveolar(BAL), Laser de Baixa Intensidade (LBI)

DESINFECÇÃO FOTOATIVADA COMO TERAPIA DAS COMPLICAÇÕES ORAIS INDUZIDAS PELA EPIDERMÓLISE BOLHOSA: RELATO DE DOIS CASOS

31 de Março de 2010

1 Centro de Atendimento a Pacientes Especiais (CAPE) - Faculdade de Odontologia - Universidade de São Paulo (USP) - Brasil .2 Divisão de Biologia Oral - Departamento de Materiais Dentários - Faculdade de Odontologia - Universidade de São Paulo (USP) - Brasil.                                                                                                                                                                                                                                                                                                                                                                                                  3 Laboratório Especial de Laser em Odontologia (LELO) - Departamento de Dentística Restauradora - Faculdade de Odontologia - Universidade de São Paulo (USP).Fabiana Martins1 Alyne Simões2Cybelle PelissariAna Cecília Correa Aranha3Marcio Oliveira1Marina Magalhães1

 

Resumo                                                                                                                                                                                                                                                                                                                      A epidermólise bolhosa distrófica recessiva (RDEB) é uma doença crônica auto-imune caracterizada pela formação de múltiplas vesículas eum risco aumentado para a formação de bolhas. A formação de bolhas e cicatrizações repetidas resultam na abertura limitada da boca, anquiloglossiae na eliminação do sulco vestibular. Entre os efeitos secundários, a reabsorção do osso alveolar, prognatismo mandibular relativo, doença periodontal e alto risco de cárie, têm sido descritos. O objetivo deste estudo é apresentar uma nova modalidade no manejo das bolhas e úlceras orais em pacientes RDEB. Duas pacientes do sexo feminino, 16 e 20 anos de idade (pacientes A e B), com RDEB, foram atendidos no Centro de Atendimento a Pacientes Especiais (CAPE), sendo a queixa principal a dor em mucosa oral e o sangramento gengival. Inicialmente, foi utilizada vaselina para lubrificar todas as regiões orais e instrumentais utilizados durante o procedimento. O tratamento periodontal convencional foi realizado sob anestesia local. Em seguida, a Desinfecção Fotoativada foi realizada empregando-se azul de metileno, como agente fotossensibilizador, em conjunto com o LASER de diodo vermelho (Twin Laser, MMOptics) em 660 nm de comprimento de onda, na dose total de 120 J/cm2, sendo que para a irradiação a gengiva foi dividida em quatro pontos de 30 J/cm2 por papilas (dois na vestibular e dois por lingual) de forma continua e em contato, 30 segundos por ponto, 40 mW com uma área despot de 0,04 cm2. Após uma semana, os pacientes apresentaram diminuição da sintomatologia dolorosa, observada através da escala analógicavisual (VAS), a qual apresentou valores diminuídos (paciente A: de 10 para5 e o B de 7 para 0). Com isto, estes achados sugerem que a desinfecção foto ativada pode representar um bom tratamento paliativo em pacientes RDEB, melhorando, sobremaneira, a qualidade de vida do paciente.                                                                                                                                                                                                                                                                                                                                         Descritores: Epidermólise bolhosa, Desinfecção fotoativada, Terapiafotodinâmica                                                                                                                                                                                                                                                                                                                                                     Abstract                                                                                                                                                                                                                                                                              Recessive dystrophic Epidermolysis bullosa (RDEB) is a rarechronic autoimmune blistering disease characterized by skin fragilityand an increased risk for blistering formation. Repeated blisteringand scar formation resulting in limited mouth opening, ankyloglossia,elimination of buccal and vestibular sulci. Among secondary effects,alveolar bone resorption, relative mandibular prognathism, periodontaldisease and high risk of caries, have been described. The aimof this study was to present a new modality of management of oralblisters and periodontal disease in RDEB patients. Two female patients,16 and 20 years of age (patients A and B), with RDEB, were seen atthe Special Care Dentistry Center, complaining about gingival bleedingand mucosal pain. Initially, vaseline was used to lubricate all oralregions and instrumentals used during the procedure. Conventionalroot scaling and gingival debridement were performed undergo localanesthesia. The methylene blue, as photosensitizer, in conjunctionwith a continuous diode LASER, 660 nm (Twin Laser, MMOptics), ata total dose of 120 J/cm2 was used. Gingiva was split into four pointsof 30 J/cm2 per papillae (two in the vestibular and two in the lingualareas), 30 sec per point, 40 mW, with a spot size of 0.04 cm2, PhotoactivatedDisinfection (PAD) was also used in ulcers and new blisteringformations in another mucosal areas with the methylene blue dyesolution. After one week, the patients were satisfied and visual analoguescale scores decreased significantly (patient A: from 10 to 5 and Bfrom 7 to 0). PAD can represent a good palliative treatment in RDEBpatients, improving patient’s quality of life.Descriptors: Periodontal disease, PAD, Photodynamic therapy (PDT)

TERAPIA FOTODINÂMICA PARA O TRATAMENTO DAS DOENÇAS PERIODONTAIS

31 de Março de 2010

1 Instituto de Física USP São Carlos, Grupo de Óptica. 

Carla Raquel Fontana1Clovis Grecco1

Vanderlei Salvador Bagnato1

Resumo                                                                                                                                                                                                                                                                                                                        A terapia fotodinâmica tem sido considerada como uma alternativa aos agentes antimicrobianos, como por exemplo aos antibióticos, para suprimir espécies bacterianas subgengivais e atuar como um tratamento adjuvante ao tratamento convencional da doença periodontal. Clinicamente, as bactérias da placa dental estão dispostas em uma massa densa e autoprotetora denominada biofilme. Quando as bactérias estão nesta condição de biofilme se mostram consideravelmente mais resistentes à terapia antimicrobiana. Vários estudos têm relatado que os microrganismos orais em culturas planctônicas 1,2,3, raspagem de placa dental 4 ou até mesmo em biofilmes5,6,7 podem ser suscetíveis à terapia fotodinâmica. Recentemente, foi mostrado que a terapia fotodinâmica ocasionou uma redução de célula bacteriana em biofilmes formados por uma única espécie (monoespecie) quando a eritrosina foi utilizada como fotossensibilizador8,9, substância esta atualmente também utilizada em dentifrícios. No entanto, outros estudos têm demonstrado destruição incompleta de patógenos orais quando amostras foram coletadas por raspagem dental10,11, em biofilmes de única espécie (monoespecies)12,13 ou em biofilmes de múltiplas espécies derivados de saliva humana14. Desta forma, neste artigo iremos apresentar e discutir as possibilidades da terapia fotodinâmica, apresentadas na literatura, para reduzir o número de bactérias em diferentes condições. As mais recentes publicações mostram que as bactérias em biofilmes são mais resistentes quando comparamos o efeito da terapia fotodinâmica em microrganismos da placa dental em fase planctônica. Estes resultados são confirmados nos estudos clínicos que serão apresentados durante a sessão de revisão de literatura.                                                                                                                                                                                                                                                                                                                                                                    Descritores: Terapia Fotodinamica, Doença periodontal, Terapiaantimicrobiana, Biofilme oral                                                                                                                                                                                                                                                                                                 Abstract                                                                                                                                                                                                                  Photodynamic therapy has been considered as an alternative to antimicrobial agents, as antibiotics, to suppress subgingivalspecies and to be an adjunctive treatment of periodontal diseases. Inclinical situation, bacteria of dental plaque are distributed withindense biofilms. This condition has been found to be considerablemore resistant to antimicrobial therapy. Several studies have reportedthat oral microorganisms in planktonic cultures1,2,3, plaque scrapings4and biofilms5,6,7 are susceptible to photodynamic therapy.Recently, it was reported that photodynamic therapy induced bacterialcell killing in oral monospecies biofilms using erythrosine8,9,which is currently used clinically as a dental plaque-disclosingagent. However, other studies have demonstrated incompletedestruction of oral pathogens in plaque scrapings10,11, monospeciesbiofilms12,13 and multispecies biofilms derived from human saliva14.In this paper we will present and discuss the ability of photodynamictherapy to reduce the number of bacteria in differentenvironments. The very recent literature shows that bacteria inbiofilms are more resistant by comparing the photodynamic effectson human dental plaque microorganisms in the planktonic phase.These results are confirmed on clinical studies that will be describedduring the literature review.Descriptors: Photodynamic therapy, Periodontal diseases, Antimicrobial

therapy, Oral biofilms

TERAPIA FOTODINÂMICA NO TRATAMENTO DO CODILOMA POR HPV

31 de Março de 2010

Instituto de Física de São Carlos - USP  Natalia Mayumi Inada Cristina KurashiMardoqueu Martins da Costa Vanderlei Salvador Bagnato                                                                                                                                                                                                                                                       Resumo                                                                                                                                                                                                                                                    A infecção genital por Papilomavírus humano (do inglês Human Papilomavirus - HPV) é a doença sexualmente transmissível (DST) de etiologia viral mais frequente na população sexualmente ativa em todo o mundo, estimando-se que a transmissão ocorra pelo contato sexual em 98% dos casos. Os dados estatísticos mais recentes indicamque a incidência desse tipo de infecção vem aumentando em quase todo o mundo, dependendo do método de diagnóstico utilizado e da população avaliada. No Brasil atinge de 10 a 40% das mulheres sexualmente ativas, principalmente as mais jovens, comum ou mais tipos do vírus. As lesões também podem ser encontradas na cavidade oral e nasal, na conjuntiva, seios paranasais, laringe, mucosa traqueobrônquica, esôfago, uretra, pele e, principalmente, no trato anogenital. Neste trabalho relatamos o desenvolvimento de um equipamento para o tratamento de lesões provenientes da infecção por HPV, de um estudo da produção e fotodegradação do fotossensibilizador utilizado durante a terapia e do protocolo clínico estabelecido com parcerias de Ribeirão Preto, Araraquara e SãoCarlos (São Paulo).                                                                                                                                                                                                                                                                                                                                                     Descritores: Terapia fotodinâmica, Papiloma vírus                                                                                                                                                                                                                                                      Abstract                                                                                                                                                                                                                                                                          It is know that human papillomaviruses (HPVs) are a familyof sexually viruses with over 200 different genotypes identified tilldate. The low-risk types primarily induce benign genital condylomasand low-grade squamous intraepithelial lesions whereasthe high-risk types are most frequently associated in 99% of cervicalcancers, with HPV16 found in about 50% of cases. They are acause of the second most common female cancer worldwide, thecancer of the cervix, and are strongly associated with several otherano-genital cancers such anal, penile, vulval and vaginal carcinomas.In this work we relate the apparatus development andclinical procedure of the PDT application on the treatment of HPVinducedlesions, and a study of the protoporphyrin IX formationand photodegradation working together with the partnership RibeirãoPreto, Araraquara and São Carlos (São Paulo).Descriptors: Photodynamic therapy, Papilllomaviruses

 

O EMPREGO DA TERAPIA FOTODINÂMICA NO CONTROLE DA CÁRIE DENTÁRIA

31 de Março de 2010

1 PhD, Instituto de Física de São Carlos - USP (IFSC).    Juçaíra Stella Martins Giusti1

2 MS, Instituto de Física de São Carlos - USP (IFSC).      Fernando Esteban Florez2

3 Full Professor, Instituto de Física de São Carlos - USP (IFSC).  Vanderlei Salvador Bagnato3

Resumo                                                                                                                                                                                                                                                               A cárie dentária, ainda hoje, figura entre as mais significativas doenças humanas, podendo afetar percentuais acima de 95% nasmais diversas populações mundiais. Por este motivo, é bastante oportuno e necessário que, novas técnicas e tecnologias sejam desenvolvida se aplicadas nas mais diversas áreas da odontologia demaneira a se conseguir um tratamento efetivo da doença cárie que seja altamente seletivo, evitando a remoção de tecido dentinário sadio, e ainda contribuindo significativamente para reduzir a ocorrência de possíveis recidivas do processo carioso. Neste contexto, surge a terapia fotodinâmica com aplicação antimicrobiana (TFDA), que pode ser considerada atualmente como um possível tratamento da lesão de cárie, uma vez que esta técnica apresenta alta seletividade, baixa toxicidade e ser de fácil aplicação. A técnica da terapia fotodinâmica pode oferecer diversas vantagens em relação a agentes antimicrobianos tradicionais. Primeiramente, a morte bacteriana é rápida, diminuindo a necessidade da manutenção de altas concentrações de substâncias químicas por longos períodos de tempo como no caso do uso de antibióticos e anti-sépticos. Em segundo lugar, como a morte das bactérias não está ligada à mediação de radicais químicos, o desenvolvimento de resistência seria improvável. Finalmente, como nem o fotossensibilizador, nem a luz empregada são bactericidas quando utilizados isoladamente, a morte das bactérias pode ser controlada restringindo-se a região irradiada, evitando adestruição da microbióta em outros locais. Baseados na revisão daliteratura e nos estudos realizados pelo nosso grupo acreditam os que a terapia fotodinâmica com aplicação antimicrobiana (TFDA) surge como um novo método de tratamento da lesão de cárie, bem como da redução bacteriana como terapia preventiva, requerendo ainda novos estudos principalmente para que se desenvolvam protocolos clínicos de aplicação.                                                                                                                                                                                                                                                                                                                                                              Descritores: Terapia Fotodinâmica, Cárie dental, Análise microbiologica, Biofilme dentário                                                                                                                                                                                                                                                         Abstract                                                                                                                                                                                                                                 Dental caries no wadays is still one of the most significan thuman diseases, affecting over than 95% of some populations. New technologies must be developed and used in different fields by dentists to get an effective treatment for the disease, avoiding theremoval of health tissue and contributing to reduce the recurrenceof dental caries. In this sense, Photodynamic Therapy to kill bacteriacould be considered a option to treat dental caries, with low toxicityand easy use. This technique can offer advantages when comparedto traditional antibiotic therapy. First, bacterial death is fast,reducing the need of high antibiotic levels for long periods andsecond, bacterial death is not mediated by chemical radicals sobacterial resistance is not probable. Another advantage is that thephotosensitizer and light can not induce bacteria killing when usedalone, so we can control the microbial reduction. Based on theliterature and in our studies we believe that Photodynamic Therapyas an antimicrobial treatment is a potential method to treat andprevent dental caries, but further studies are necessary mainly toestablish clinical protocols.Descriptors: Photodyinamic therapy, Dentine caries, Microbiologicalanalysis

CONTROLE MICROBIANO COM AÇÃO FOTODINÂMICA: UMA REVISÃO DA PRESENTE TENDÊNCIA MUNDIAL

31 de Março de 2010

1 Professor Titular do Instituto de Física de São Carlos - Universidade  de São Paulo   Vanderlei S. Bagnato

2 Professora Doutora do Instituto de Física de São Carlos - Universidade de São Paulo Cristina Kurachi

Resumo                                                                                                                                                                                                                                                                                                                                       O uso de terapia Fotodinâmica (TFD) como base para controle microbiano, é um tema que praticamente nasceu com a idéia desta técnica terapêutica. Com a previsão do fim da era dos antibióticos, causada pela resistência ao tratamento desenvolvida pelos microrganismos, a técnica de PDT para controle microbiano, passa a ter uma importância imperativa. Neste artigo, procuramos fazer uma breve revisão, longe de ser completa, sobre as aplicações mais comuns. O campo é ainda novo, estando em franco crescimento e tendo espaço para grandes contribuições de diversos grupos.                                                                                                                                                                                                                                                                                                                                                                       Descritores: Terapia fotodinâmica, Controle microbiano                                                                                                                                                                                                                                                                                                                                                            Abstract                                                                                                                                                                                                                                                                                                              The use of Photodynamic therapy (PDT) as a basis for microbial control is an issue that was virtually born withthe idea of  this therapeutic technique. With the predictedend of the antibiotics era, caused by the growing resistance developed by microorganisms, the technique of PDT for the microbial control appears with an imperative importance.We present a brief review, far from complete, on the mostcommon applications. This field is still new and is growing.There seems to be room for great contributions of all researchgroups.                                                                                                                                                                                                                                                                                                                                                   Descriptors: Photodynamic Therapy, Microbial Control 

ABLAÇÃO DE DENTES BOVINOS E HUMANOS COM LASER DE TI:SAFIRA NO REGIME DE FEMTOSSEGUNDOS: ANÁLISES MORFOLÓGICAS E FÍSICO-QUÍMICAS

22 de Fevereiro de 2010

1 Instituto de Física de São Carlos - USP: Maristela Dutra-Corrêa3, 1 Gustavo Nicolodelli1 Kurachi Cristina1 Vanderlei Salvador Bagnato1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             2 Faculdade de Odontologia de São José dos Campos - UNESP: José Roberto Rodrigues23 Universidade Paulista - UNIP                                                                                                                                                                                                                                                                                                                                                                  Resumo                                                                                                                                                                                                                                                                  Dentes bovinos têm sido convencionalmente utilizados em pesquisas odontológicas substituindo dentes humanos. Diferenças nas propriedades físico-químicas, estruturais e morfológicas dos substratos representarão diferenças na resposta frente a diversos tratamentos. Foi investigada a ablação em esmalte e dentina de dentes bovinos (30) e humanos (30) com laser de Ti:Safira, no regime de femtossegundos(70 fs), com ë= 800±1 nm, taxa de repetição=1 KHz, utilizando diferentes potências médias com diferentes tempos de exposição. Foram realizadas análises morfológicas e físico-químicas. Os corpos-de-prova foram observados ao microscópio de luz, ao MEV e analisados por EDX. As microcavidades em esmalte (bovino e humano) apresentaram ablação precisa, integridade e definição das margens. No esmalte humano não houve danos térmicos ou microfraturas; o bovino apresentou microfraturas, provavelmente resultado de sua menor resistência à ablação com laser. As microcavidades da dentina (bovina e humana)apresentaram bordas definidas, entretanto com microfraturas, sendo que na dentina bovina foram mais numerosas, mais amplas e maisintensas, mostrando maior susceptibilidade frente à irradiação com laser. Quanto à proporção Ca/P, as alterações proporcionais entre números de átomos de Ca em relação ao P, não foram estatisticamente significantes, para nenhum tecido. Conclui-se que o laser de Ti:Safirano regime de femtossegundos (fs), além de muito rápido, potente e seguro, tem a vantagem de poder ser bem controlado e preciso, promovendo profundidades pequenas e específicas. Diante dos resultados e dependendo do tipo de tecido, fica evidente a necessidade de prévio conhecimento das diferenças entre eles antes da direta extrapolação dos resultados obtidos em substrato bovino para humano.                                                                                                                                                                                                                                                                                                                                Descritores: Dente, humano e bovino; dentina; esmalte dentário; laser, ablação, Ti:Safira, femtossegundos; espectroscopia por energia dispersiva de raios-x (EDX ou EDS); microscopia eletrônica de varredura (MEV)                                                                                                                                                                                                                                                                                                                                                  Abstract                                                                                                                                                                                                                                                                                                          Bovine teeth have been conventionally used in dental research toreplace human teeth. Differences in the physicoc hemical, structuraland morphological properties of these substrates cause differences intheir response to several treatments. This study investigated the ablationof enamel and dentin of bovine teeth (30) and human teeth (30) usinga Ti:Sapphire laser at Femtosecond (fs) pulse width (70fs), ë= 800±1 nmand repetition rate of 1 KHz. Different output power levels and irradiationtimes were investigated. Morphological and physicochemical analysis were conducted. Irradiated specimens were evaluated underlight microscopy, SEM and EDX. Microcavities in bovine and humanenamel showed accurate ablation, with sharp margins and preservedmorphologies. Human enamel did not exhibit induced thermal damageor microfractures; bovine enamel presented microfractures, probablydue a lower resistance to laser ablation. The microcavities in dentin(bovine and human) presented defined borders, yet with microfractures,which were more frequent, wider and more intense in the bovinedentin, demonstrating a higher susceptibility to laser irradiation.Concerning the Ca/P ratio, the proportional alterations between thenumbers of Ca atoms compared to P atoms were not statisticallysignificant for any tissue. In this study Femtosecond Ti:Sapphire lasershowed to be a fast, powerful and safe ablation system. Additionally,it promotes removal at small and specific depths. Considering thepresent results and depending on the type of tissue, it is clear thatprevious knowledge on the differences between them is required beforedirect extrapolation of results obtained in bovine substrate to thehuman substrate.                                                                                                                                                                                                                                                                                                                                                                                         Descriptors: Tooth, human and bovine; dentin; dental enamel;ablation; Ti:Sapphire; laser; Femtosecond; Energy Dispersive X-raySpectroscopy (EDX or EDS); Scanning Electron Microscope (SEM)                                                                                                                                                                                                                                                                                                                          Contato: E-mail: maristeladcb@uol.com.br