Photobiomodulation in Sciatic Nerve Crush Injuries in Rodents: A Systematic Review of the Literature and Perspectives for Clinical Treatment

Introduction: The aim of the study was to perform a literature review to analyze the effect of photobiomodulation in experimental studies on peripheral nerve regeneration after sciatic nerve crush injury in rodents.Methods: A bibliographic search was performed in the electronic databases, including MEDLINE (PubMed), SCOPUS, and SciELO, from 2008 to 2018.Results: A total of 1912 articles were identified in the search, and only 19 fulfilled all the inclusion criteria. Along with the parameters most found in the manuscripts, the most used wavelengths were 660 nm and 830 nm, power of 30 and 40 mW, and energy density of 4 and 10 J/cm2. For total energy throughout the intervention period, the lowest energy found with positive effects was 0.70 J, and the highest 1.141 J. Seventeen studies reported positive effects on nerve regeneration. The variables selected to analyze the effect were: Sciatic Functional Index (SFI), Static Sciatic Index (SSI), morphometric, morphological, histological, zymographic, electrophysiological, resistance mechanics and range of motion (ROM). The variety of parameters used in the studies demonstrated that there is yet no pre-determined protocol for treating peripheral nerve regeneration. Only two studies by different authors used the same power, energy density, beam area, and power density.Conclusion: It was concluded that the therapeutic window of the photobiomodulation presents a high variability of parameters with the wavelength (632.8 to 940 nm), power (5 to 170 mW) and energy density (3 to 280 J /cm2), promoting nerve regeneration through the expression of cytokines and growth factors that aid in modulating the inflammatory process, improving morphological aspects, restoring the functionality to the animals in a brief period.Keywords: Phototherapy; Nerve regeneration; Sciatic nerve; Experimental studies; Injury; Lasers and light sources

Levantamiento y cruzamiento de las informaciones sobre evaluación clínica, diagnóstico e intervenciones de fisioterapia

Objetivo: descrever a experiência para desenvolver um registro eletrônico em fisioterapia baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde através do mapeamento e cruzamento de informações da avaliação clínica, diagnóstico e intervenções fisioterapêuticas. Método: relato de experiência, organizado em quatro etapas: Aprofundamento teórico da Classificação Internacional de Funcionalidade; Aprofundamento teórico da avaliação em fisioterapia; Estruturação dos dados de avaliação, dos diagnósticos e intervenção fisioterapêutica; Informatização e integração de forma sistematizada dos dados da avaliação clínica, dos diagnósticos e intervenções. Resultados: a estruturação dos dados foi dividida por sistemas do corpo humano. Sendo assim, para o sistema respiratório construiu-se 15 tópicos de avaliação, 145 diagnósticos e 74 intervenções; para o sistema neuromusculoesquelético construiu-se 37 tópicos de avaliação, 132 diagnósticos e 65 intervenções; para o sistema cardiovascular construiu-se cinco tópicos de avaliação, 23 diagnósticos e cinco intervenções e para o sistema gastrointestinal e renal construiu-se sete tópicos de avaliação, 21 diagnósticos e uma intervenção. Desta forma, foram construídos 64 itens de avaliação, 318 diagnósticos baseados na Classificação de Funcionalidade e 145 intervenções fisioterapêuticas. Conclusão: o mapeamento das informações sobre avaliação fisioterapêutica, diagnósticos e intervenções para integrar um registro eletrônico em fisioterapia tornará o uso da Classificação Internacional de Funcionalidade, Incapacidade e Saúde mais segura e rápida possibilitando sua aplicabilidade diária na clínica hospitalar.Objective: to describe the experience of developing an electronic health record in physiotherapy based on the International Classification of Functioning Disability and Health through the mapping and cross-referencing of clinical evaluation information, diagnosis and physiotherapeutic interventions. Method: an experience report, organized in four stages: Theoretical development of the International Classification of Functionality; Theoretical development of evaluation in physiotherapy; Structuring of evaluation data, diagnoses and physiotherapeutic intervention; Computerization and systematized integration of data from clinical evaluation, diagnoses and interventions. Results: the structure of the data was divided by systems of the human body. Thus, for the respiratory system, 15 evaluation topics, 145 diagnoses and 74 interventions were constructed; for the neuromusculoskeletal system, 37 evaluation topics, 132 diagnoses and 65 interventions were constructed; for the cardiovascular system, five evaluation topics, 23 diagnoses and five interventions were constructed; and seven assessment topics, 21 diagnoses and one intervention were constructed for the gastrointestinal and renal systems. Thus, 64 evaluation items were constructed, 318 diagnoses based on the Functionality Classification and 145 physiotherapeutic interventions. Conclusion: the mapping of information regarding physiotherapeutic evaluation, diagnoses and interventions to integrate an electronic physiotherapy records will make use of the International Classification of Functioning, Disability and Health safer and faster, allowing it to be applied in the hospital setting.Objetivo: describir la experiencia para desarrollar un registro electrónico en fisioterapia basado en la Clasificación Internacional de Funcionalidad, Incapacidad y Salud a través del levantamiento y cruzamiento de informaciones de la evaluación clínica, diagnóstico e intervenciones fisioterapéuticas. Método: relato de experiencia realizado en cuatro etapas: Profundización teórica de la Clasificación Internacional de Funcionalidad; Profundización teórica de la evaluación en fisioterapia; Estructuración de los datos de evaluación, diagnósticos e intervención fisioterapéutica; Informatización e integración de forma sistematizada de los datos de la evaluación clínica, diagnósticos e intervenciones. Resultados: la estructuración de los datos fue dividida por sistemas del cuerpo humano. Así, para el sistema respiratorio se construyeron 15 tópicos de evaluación, 145 diagnósticos y 74 intervenciones. Para el sistema neuromusculoesquelético se construyeron 37 tópicos de evaluación, 132 diagnósticos y 65 intervenciones. Para el sistema cardiovascular se construyeron cinco tópicos de evaluación, 23 diagnósticos y cinco intervenciones y para el sistema gastrointestinal y renal se construyeron siete tópicos de evaluación, 21 diagnósticos y una intervención. De esta forma, se construyeron 64 ítems de evaluación, 318 diagnósticos basados en la Clasificación de Funcionalidad y 145 intervenciones fisioterapéuticas. Conclusión: el levantamiento de las informaciones sobre la evaluación fisioterapéutica, diagnósticos e intervenciones para integrar un registro electrónico en fisioterapia hará que el uso de la Clasificación Internacional de Funcionalidad, Incapacidad y Salud sea más seguro y rápido, posibilitando su aplicabilidad diaria en la clínica hospitalaria.info:eu-repo/semantics/publishedVersio

Desenvolvimentos Recentes em Técnicas de Anastomose para Cirurgia Gastrointestinal: Uma Revisão

This article provides a comprehensive review of recent developments in anastomosis techniques for gastrointestinal surgery, highlighting innovations that promise to transform surgical practice and improve patient outcomes. Through a meticulous search strategy in scientific databases, relevant studies exploring both conventional and emerging techniques, including magnetic compression anastomosis, application of seromuscular sutures, and ultrasound endoscopy (EUS)-guided anastomosis, were identified. The findings suggest that such innovations offer significant advantages, such as reducing post-operative complications and improving patient recovery. The discussion emphasizes the importance of continuing education and professional development, as well as the need for randomized clinical trials to validate the benefits of these techniques. The conclusion reiterates the potential of these innovations to enhance patients' quality of life, highlighting the need for evidence-based approaches in adopting new surgical technologies. This review underscores the dynamic evolution of anastomosis techniques and the significance of informed research and clinical practice to advance in gastrointestinal surgery.Este artigo apresenta uma revisão abrangente dos desenvolvimentos recentes em técnicas de anastomose para cirurgia gastrointestinal, destacando inovações que prometem transformar a prática cirúrgica e melhorar os desfechos para os pacientes. Através de uma estratégia de busca meticulosa em bases de dados científicas, foram identificados estudos relevantes que exploram técnicas convencionais e emergentes, incluindo anastomose por compressão magnética, aplicação de suturas em camada seromuscular e anastomose guiada por ultrassonografia endoscópica (EUS). Os resultados indicam que tais inovações oferecem vantagens significativas, como redução de complicações pós-operatórias e melhoria na recuperação dos pacientes. A discussão enfatiza a importância da educação contínua e do desenvolvimento profissional, bem como a necessidade de ensaios clínicos randomizados para validar os benefícios dessas técnicas. A conclusão reitera o potencial dessas inovações para melhorar a qualidade de vida dos pacientes, destacando a necessidade de abordagens baseadas em evidências na adoção de novas tecnologias cirúrgicas. Esta revisão evidencia a evolução dinâmica das técnicas de anastomose e a importância de pesquisa e prática clínica informadas para avançar na cirurgia gastrointestinal

Triblock copolymer nanovesicles for pH-responsive targeted delivery and controlled release of siRNA to cancer cells

New pH-responsive polymersomes for active anticancer oligonucleotide delivery were prepared from triblock copolymers. The delivery systems were formed by two terminal hydrophilic blocks, PEG and polyglycerolmethacrylate (poly-GMA), and a central weakly basic block, polyimidazole-hexyl methacrylate (poly-ImHeMA), which can complex with oligonucleotides and control vesicle formation/disassembly via pH variations. Targeted polymersomes were prepared by mixing folate-derivatized and underivatized copolymers. At pH 5, ds-DNA was found to complex with the pH-responsive copolymers at a N/P molar ratio above ∼2:1, which assisted the encapsulation of ds-DNA in the polymersomes, while low association was observed at pH 7.4. Cytotoxicity studies performed on folate receptor overexpressing KB and B16–F10 cells and low folate receptor expressing MCF-7 cells showed high tolerance of the polymersomes at up to 3 mg/mL concentration. Studies performed with red blood cells showed that at pH 5.0 the polymersomes have endosomolytic properties. Cytofluorimetric studies showed a 5.5-fold higher uptake of ds-DNA loaded folate-functional polymersomes in KB cells compared to nontargeted polymersomes. In addition, ds-DNA was found to be localized both in the nucleus and in the cytosol. The incubation of luciferase transfected B16–F10 cells with targeted polymersomes loaded with luciferase and Hsp90 expression silencing siRNAs yielded 31 and 23% knockdown in target protein expression, respectively

Control of aggregation temperatures in mixed and blended cytocompatible thermoresponsive block co-polymer nanoparticles

A small library of thermoresponsive amphiphilic copolymers based on polylactide-block-poly((2-(2-methoxyethoxy)ethyl methacrylate)-co-(oligoethylene glycol methacrylate)) (PLA-b-P(DEGMA)-co-(OEGMA)), was synthesised by copper-mediated controlled radical polymerisation (CRP) with increasing ratios of OEGMA:DEGMA. These polymers were combined in two ways to form nanoparticles with controllable thermal transition temperatures as measured by particle aggregation. The first technique involved the blending of two (PLA-b-P(DEGMA)-co-(OEGMA)) polymers together prior to assembling NPs. The second method involved mixing pre-formed nanoparticles of single (PLA-b-P(DEGMA)-co-(OEGMA)) polymers. The observed critical aggregation temperature Tt did not change in a linear relationship with the ratios of each copolymer either in the nanoparticles blended from different copolymers or in the mitures of pre-formed nanoparticles. However, where co-polymer mixtures were based on (OEG)9MA ratios within 5-10 mole% , a linear relationship between (OEG)9MA composition in the blends and Tt was obtained. The data suggest that OEGMA-based copolymers are tunable over a wide temperature range given suitable co-monomer content in the linear polymers or nanoparticles. Moreover, the thermal transitions of the nanoparticles were reversible and repeatable, with the cloud point curves being essentially invariant across at least three heating and cooling cycles, and a selected nanoparticle formulation was found to be readily endocytosed in representative cancer cells and fibroblasts

Providing a nurse-led complex nursing INtervention FOcused on quality of life assessment on advanced cancer patients: The INFO-QoL pilot trial.

PURPOSE Unmet needs for advanced-disease cancer patients are fatigue, pain, and emotional support. Little information is available about the feasibility of interventions focused on patient-reported outcome measurement developed according to the Medical Research Council (MRC) Framework in advanced-disease cancer patients. We aimed to pilot a nurse-led complex intervention focused on QoL assessment in advanced-disease cancer patients. METHODS The INFO-QoL study was based on an exploratory, nonequivalent comparison group, pre-test-post-test design. Study sites received either the INFO-QoL intervention or usual care. Adult advanced-disease cancer patients admitted to hospice inpatient units that gave their informed consent were included in the study. Subjects were 187 patients and their families and 19 healthcare professionals. We evaluated feasibility, acceptability, and patients' outcomes using the Integrated Palliative Care Outcome Scale. RESULTS Nineteen healthcare professionals were included. The mean competence score increased significantly over time (p < 0.001) and the mean usefulness score was high 8.63 (±1.36). In the post-test phase, 54 patients were allocated to the experimental unit and 36 in the comparison unit. Compared to the comparison unit, in the experimental unit anxiety (R2 = 0.07; 95% CI = -0.06; 0.19), family anxiety (R2 = 0.22; 95% CI = -0.03; 0.41), depression (R2 = 0.31; 95% CI = -0.05; 0.56) and sharing feelings (R2 = 0.09; 95% CI = -0.05; 0.23), were improved between pre-test and post-test phase. CONCLUSIONS The INFO-QoL was feasible and potentially improved psychological outcomes. Despite the high attrition rate, the INFO-QoL improved the quality and safety culture for patients in palliative care settings

Plataforma Ensinando o Lattes / Platform teaching Lattes

O grupo do programa de educação tutorial em Odontologia (PET Odontologia - UNESP) da Universidade Estadual Paulista, UNESP, Faculdade de Odontologia de Araraquara, São Paulo, Brasil, com o apoio de seu tutor e vice-diretora, criaram e publicaram uma plataforma voltada para graduandos, intitulada “Plataforma Ensinando o Lattes”, em junho de 2020. Para ensinar o correto preenchimento da Plataforma Lattes, o material didático foi produzido em PDF e publicado via internet. Composto por tutoriais simples, instruções básicas e dividido em dez módulos, abordou os itens mais utilizados da produção curricular durante a graduação. A plataforma foi divulgada nas redes sociais do PET Odontologia - UNESP. Observou-se que a “Plataforma de Ensino Lattes” atingiu um grande público. Recebeu 1.051 acessos no Instagram e, entre eles, 106 usuários salvaram o documento. O site contabilizou 635 visitas. Os resultados mostraram que a “Plataforma Ensinando o Lattes” constitui um material instrucional de grande valor para os graduandos na construção e atualização do currículo

Evidências sobre o tratamento cirúrgico do melanoma metastático / Evidence on surgical treatment of metastatic melanoma

A incidência de melanoma cutâneo tem aumentado nas últimas décadas, enquanto os pacientes com melanoma em estágio inicial, I ou II, têm um prognóstico favorável com a cirurgia como o principal e único tratamento necessário, e aqueles com melanoma em estágio III ou IV têm prognóstico pior. A cirurgia continua a ter um papel fundamental no tratamento em face dessas terapias sistêmicas mais eficazes para melanoma avançado e pode estar associada a uma melhor sobrevida em longo prazo. Os pacientes com suspeita de doença metastática à distância devem ser submetidos a uma avaliação abrangente para avaliar os locais e a carga da doença antes de considerar a cirurgia. O fígado e o SNC são locais comuns e frequentemente a causa de morte por melanoma metastático. Outros locais incluem pele, pulmão, nódulos linfáticos, trato gastrointestinal, glândula adrenal, pâncreas, baço e osso.

Resumos em andamento - Residência Multiprofissional

Resumos em andamento - Residência Multiprofissiona