Effects of electrophysical resources in osteoporosis: a review of the literature

OBJECTIVE: The aim of this article was to provide a literature review regarding the impact of the main eletrophysical resources used on the acceleration of bone metabolism and on the osteoporosis treatment. DEFINITION: The OMS defines osteoporosis as a Sistemic esqueletical disease characterized for diminished bone mass and for deterioration of the bone mass microarchitecture, increasing the bone fragility and susceptibility to fracture. Many drug or non-drug treatments are being developed as an attempt to increase the bone mass, and prevent osteoporosis. Within this context, the eletrophysical resources is having a prominence paper, as a resource which presents a osteogenic potencial, capable of stimulating the proliferation of osteoblasts and biomodulate the bone metabolism. RESEARCH STRATEGIES: The data base consulted were: The Cochrane Library, MEDLINE, Embase, LILACS, SciELO, references of indentified articles and contact with laser's especialists, between 1983 and 2009. SELECTION CRITERIA: Were included experimental study and randomized clinical tests on the effects of eletrophysical resources on osteoporosis. RECOMPILATION AND DATA ANALISIS: Two reviewers independently selected the studies, assessed their methodological quality and collected the data. RESULTS: All the eletrophysical resources quoted on this article were effective in stimulation of bone metabolism. However, most of the studies show these effects through in vitro studies and experimental studies with animals. It is important to say that experiments like these are rare in human beings. Based on the findings of this review, it may be suggested that the eletrophysical resources like lasertherapy, ultra-sound, electromagnetic fields and vibration are resources that has osteogenic potencial, but more studies are needed to define the effects of it in humans, as well as more effective treatment protocols. CONCLUSION: With this literature review it is clear that eletrophysical resources have high osteogenic potential, but most of the studies are in vitro. It is needed more studies in vivo, defining therefore, better parameters and doses to be used in the treatment of osteoporosis.OBJETIVO: Fazer uma revisão bibliográfica a respeito dos efeitos dos principais recursos eletrofísicos utilizados na aceleração do metabolismo ósseo e no tratamento da osteoporose. ANTECEDENTES: A Organização Mundial da Saúde (OMS) define a osteoporose como doença esquelética sistêmica caracterizada por diminuição da massa óssea e deterioração microarquitetural do tecido ósseo, com consequente aumento da fragilidade óssea e susceptibilidade à fratura. Vários tratamentos medicamentosos e não medicamentosos vêm sendo desenvolvidos na tentativa de aumentar a massa óssea e prevenir a osteoporose. Dentro desse contexto, os recursos eletrofísicos vêm tendo um papel de destaque, como recursos que apresentam um potencial osteogênico, capazes de estimular a proliferação de osteoblastos e biomodular o metabolismo ósseo. ESTRATÉGIA DE PESQUISA: Foram consultadas as bases de dados: The Cochrane Library, MEDLINE, Embase, LILACS, SciELO, referências dos artigos identificados, e contato com especialisas em laser, entre os anos de 1983 e 2009. CRITÉRIOS DE SELEÇÃO: Foram incluídos estudos experimentais e ensaios clínicos randomizados que avaliaram os efeitos dos recursos eletrofísicos na osteoporose. RECOMPILAÇÃO E ANÁLISE DE DADOS: Dois revisores selecionaram independentemente os estudos, avaliaram sua qualidade metodológica dos estudos e coletaram os dados. RESULTADOS: Todos os recursos eletrofísicos citados neste artigo se mostraram eficazes na estimulação do metabolismo ósseo. No entanto, a grande maioria dos estudos realizados evidenciam esses efeitos através de estudos in vitro e estudos experimentais com cobaias. Cabe ressaltar que trabalhos como esses são raros em seres humanos. Baseado nos achados desta revisão pode ser sugerido que os recursos eletrofísicios como o laser terapêutico, o ultrassom, campos eletromagnéticos e plataformas vibratórias são recursos que tem um potencial osteogênico entretanto mais estudos são necessários para definir os efeitos dos mesmos em humanos, bem como, protocolos mais eficazes de tratamento. CONCLUSÃO: A partir deste levantamento bibliográfico, fica evidente que os recursos eletrofísicos apresentam um grande potencial osteogênico, porém, a maior parte dos estudos é in vitro. São necessários mais estudos in vivo, definindo, assim, melhores parâmetros e doses, para que sejam utilizados no tratamento da osteoporose.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São CarlosUNIFESPSciEL

Biomaterial Property Effects on Platelets and Macrophages: An in Vitro Study

The purpose of this study was to evaluate the effects of surface properties of bone implants coated with hydroxyapatite (HA) and beta-tricalcium phosphate (beta-TCP) on platelets and macrophages upon implant installation and compare them to grit-blasted Ti and Thermanox used as a control. Surface properties were characterized using scanning electron microscopy, profilometry, crystallography, Fourier transform infrared spectroscopy, and coating stability. For platelets, platelet adherence and morphology were assessed. For macrophages, morphology, proliferation, and polarization were evaluated. Surface characterization showed similar roughness of similar to 2.5 mu m for grit-blasted Ti discs, both with and without coating. Coating stability assessment showed substantial dissolution of HA and beta-TCP coatings. Platelet adherence was significantly higher for grit-blasted Ti, Ti-HA, and Ti-beta-TCP coatings compared to that of cell culture control Thermanox. Macrophage cultures revealed a decreased proliferation on both HA and beta-TCP coated discs compared to both Thermanox and grit-blasted Ti. In contrast, secretion of pro-inflammatory cytokine TNF-alpha and anti-inflammatory cytokine TGF-beta were marginal for grit-blasted Ti and Thermanox, while a coating-dependent increased secretion of pro- and anti-inflammatory cytokines was observed for HA and beta-TCP coatings. The results demonstrated a significantly upregulated pro-inflammatory and anti-inflammatory cytokine secretion and marker gene expression of macrophages on HA and beta-TCP coatings. Furthermore, HA induced an earlier M1 macrophage polarization but more M2 phenotype potency than beta-TCP. In conclusion, our data showed that material surface affects the behaviors of first cell types attached to implants. Due to the demonstrated crucial roles of platelets and macrophages in bone healing and implant integration, this information will greatly aid the design of metallic implants for a higher rate of success in patients.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Radboudumc, Dept Biomat, POB 9101, NL-6500 HB Nijmegen, NetherlandsFed Univ Sao Paulo UNIFESP, Dept Biosci, 136 Silva Jardim St, BR-11015021 Santos, SP, BrazilFed Univ Sao Paulo UNIFESP, Dept Biosci, 136 Silva Jardim St, BR-11015021 Santos, SP, BrazilCAPES: 9424/2014-08Web of Scienc

Morphological aspects and Cox-2 expression after exposure to 780-nm laser therapy in injured skeletal muscle: an in vivo study

Background:The effectiveness of low-level laser therapy in muscle regeneration is still not well known. Objective: To investigate the effects of laser irradiation during muscle healing.Method: For this purpose, 63 rats were distributed to 3 groups: non-irradiated control group (CG); group irradiated at 10 J/cm² (G10); and group irradiated at 50 J/cm² (G50). Each group was divided into 3 different subgroups (n=7), and on days 7, 14 and 21 post-injury the rats were sacrificed.Results:Seven days post-surgery, the CG showed destroyed zones and extensive myofibrillar degeneration. For both treated groups, the necrosis area was smaller compared to the CG. On day 14 post-injury, treated groups demonstrated better tissue organization, with newly formed muscle fibers compared to the CG. On the 21st day, the irradiated groups showed similar patterns of tissue repair, with improved muscle structure at the site of the injury, resembling uninjured muscle tissue organization. Regarding collagen deposition, the G10 showed an increase in collagen synthesis. In the last period evaluated, both treated groups showed statistically higher values in comparison with the CG. Furthermore, laser irradiation at 10 J/cm2 produced a down-regulation of cyclooxygenase 2 (Cox-2) immunoexpression on day 7 post-injury. Moreover, Cox-2 immunoexpression was decreased in both treated groups on day 14.Conclusions:Laser therapy at both fluencies stimulated muscle repair through the formation of new muscle fiber, increase in collagen synthesis, and down-regulation of Cox-2 expression.Universidade Federal de São Carlos Departamento de FisioterapiaUniversidade Estadual de Campinas Faculdade de Ciências Médicas Departamento de CirurgiaUniversidade de São Paulo Departamento de Biomecânica, Medicina e Reabilitação do Sistema LocomotorUniversidade Federal de São Paulo (UNIFESP) Departamento de BiociênciasUNIFESP, Depto. de BiociênciasSciEL

Effects of low-intensity pulsed ultrasound on injured skeletal muscle

BACKGROUND:Low-intensity pulsed ultrasound (LIPUS) has been shown to stimulate tissue metabolism and accelerate muscle healing. However, the optimal parameters in the use of LIPUS are still not clear.OBJECTIVE:The aim of this study was to analyze the effects of LIPUS on muscle healing in rats subjected to a cryolesion.METHOD:Twenty rats were divided into the following groups: an injured control group (CG) and an injured treated group (TG). Both groups were divided into 2 sub-groups (n=5 each) that were sacrificed 7 and 13 days post-surgery. Treatments were started 24 hours after the surgical procedure and consisted of 3 or 6 sessions. After euthanasia, the muscles were submitted to standard histological procedures.RESULTS:Qualitative analyses were based on morphological assessments of the muscle. The histopathological analysis on day 7 revealed that the muscles in the CG and the TG presented an intense inflammatory infiltrate, a large necrotic area and a disorganized tissue structure. After 13 days, both the CG and the TG had granulation tissue and newly formed fibers. The TG presented a more organized tissue structure. The quantitative analysis of collagen indicated similar findings among the groups, although the qualitative analysis revealed a better organization of collagen fibers in the TG at 13 days. The immunohistochemical analysis indicated that, at both time points, the expression of cyclooxygenase-2 was upregulated in the TG compared to the CG.CONCLUSIONS: LIPUS used as a treatment for muscle injury induced a more organized tissue structure at the site of the injury and stimulated the expression of COX-2 and the formation of new muscle fibers.Universidade Federal de São Paulo (UNIFESP) Department of BiosciencesUniversidade Federal de São Carlos Physical Therapy DepartmentUNIFESP, Department of BiosciencesSciEL

Comparison of the effects of low-level laser therapy and low-intensity pulsed ultrasound on the process of bone repair in the rat tibia

BACKGROUND: Electrophysical agents such as Ultrasound (US) and low-level laser therapy (LLLT) have been increasingly used in physical therapy practice. Studies suggest that these devices are able to stimulate osteoblast proliferation and osteogenesis at the fracture site, resulting in a greater deposition of bone mass and speeding up the consolidation process. OBJECTIVE: The aim of this study was to analyze the effects of US and LLLT on the bone healing process, through biomechanical and histological analysis of the bone callus. METHODS: A total of 30 rats were randomly allocated into three groups: control group fracture without treatment (GC); fracture group treated with pulsed US, burst 1.5 MHz, 200us, 1KHz, 30 mW/cm² (GUS) and fracture group treated with laser 830nm, 100mW, 120J/cm² (GL). Bone defects were performed with a circular drill of 2mm in diameter in the animal's tibias. The treatments were carried out after surgery consisting of 7 applications every 48 hours. After 14 days the animals were sacrificed and the tibias were removed to perform the analysis, being the right tibia designated for biomechanical analysis, while the left tibia for histological analysis. RESULTS: The biomechanical analysis showed no statistically significant difference between biomechanical properties of the CG, CL and GUS. In morphometric analysis, both GUS and GL showed a significantly higher woven bone tissue area compared to the control group. However, when the two treatment modalities were compared, there were no statistical differences between them. CONCLUSION: Both devices used in this study were able to accelerate the bone healing process in rats.CONTEXTUALIZAÇÃO: Recursos eletrofísicos, como o ultrassom (US) e a terapia laser de baixa potência (LLLT), vêm sendo cada vez mais utilizados na prática fisioterapêutica. Estudos sugerem que esses recursos são capazes de estimular a proliferação de osteoblastos e a osteogênese no local da fratura, promovendo maior deposição de massa óssea e acelerando o processo de consolidação. OBJETIVO: Analisar os efeitos do US e da LLLT no processo de consolidação óssea por meio das análises biomecânica e histológica do calo ósseo. MÉTODOS: Foram utilizados 30 ratos machos, distribuídos aleatoriamente em três grupos: grupo controle fratura, sem tratamento (GC); grupo fratura tratado com US pulsado com burst de 1,5 MHz, 200us, 1KHz, 30 mW/cm² (GUS) e grupo fratura tratado com laser 830nm, 100mW, 120J/cm² (GL). Foram realizados defeitos ósseos circulares com broca de 2 mm de diâmetro nas tíbias dos animais. Os tratamentos foram realizados a cada 48 horas, totalizando sete aplicações e, no 14º dia, os animais foram sacrificados. A tíbia direita foi designada para análise biomecânica, enquanto a esquerda, para análise histológica. RESULTADOS: A análise biomecânica não mostrou diferença estatisticamente significativa entre as propriedades biomecânicas do GC, GL e GUS. Na análise morfométrica, tanto GUS quanto GL apresentaram área de osso neoformado estatisticamente maior em relação ao GC. No entanto, quando as duas modalidades de tratamento foram comparadas, não foram encontradas diferenças estatísticas entre elas. CONCLUSÃO: Ambos os recursos utilizados neste estudo foram capazes de acelerar o processo de reparo ósseo em ratos.Universidade Federal de São CarlosUFSCar Departamento de Ciências FisiológicasUniversidade Federal de São Paulo (UNIFESP) Departamento de BiociênciasUNIFESP, Depto. de BiociênciasSciEL

Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio