Antonio Balbin Villaverde

Pulmonary fibrosis (PF) is a frequent long-term complication in post-COVID-19 patients, reducing lung capacity, unblocking pro-fibrotic cells and leading to lung scarring. Photobiomodulation (PBM) is a promising technique in reducing inflammation and cytokine storm and is strongly indicated for post-COVID-19 patients to improve cardiopulmonary functions and reduce respiratory distress. Objective: To verify the efficacy of PBM in association with physical therapy rehabilitation in patients with post-COVID-19 PF. Materials and Methods. The cohort consisted of 30 patients undergoing treatment for COVID-19, distributed into three groups of 10 patients: PBM1, PBM2 and Sham. PBM used a vest containing 300 LEDs (l=940nm) distributed in 2088 cm², with a total optical power of 6 W, which was positioned over the thoracoabdominal region. Physiotherapy care was performed twice a week for 6 weeks, with FBM previously applied for 15 minutes. Pulmonary function, respiratory muscle strength, pulmonary conditioning, dyspnea on exertion and SpO2% were assessed. Statistical analysis used two unpaired Student's t-tests, tailed with p<0.05. Results: Regarding MIP, MEP and FEV1, it was observed that the FBM1 group showed a statistically significant improvement in pulmonary recovery in relation to the FBM2 group, for the three variables. The analysis of lung capacity for the 6MWT (6-Minute Walk Test), FBM1 vs FBM2 and FBM1 vs Sham showed a statistical difference with p<0.001. Conclusion: FBM in association with cardiopulmonary rehabilitation after COVID-19 was extremely relevant for the recovery of pulmonary function in patients affected by PF.

This study aimed to compare shoulder tendinopathy treatment with therapeutic ultrasound combined with LED photobiomodulation therapy using LED-infrared (850 nm) or LED-red (640 nm). The study assessed 75 patients, aged 45 to 70 years, distributed into five experimental groups (15 patients each): therapeutic ultrasound (US), infrared light irradiation (IR), visible red light irradiation (VR), infrared light and ultrasound combined (IR-US), and red light in conjunction with ultrasound (VR-US). The ultrasound parameters are 1 MHz, 0.5 W/cm² (SATA), and 100 Hz repetition rate, applied for 4 min each session. LED irradiation protocols were as follows: 3 points, 7.5 J per point, IR-LED 750 mW, 10 s, VR-LED 250 mW, 30 s. LED irradiation is followed by ultrasound in the combined therapies. The efficiency of the five therapies was evaluated assessing 12 parameters: quality of life (Health Assessment Questionnaire, HAQ), pain intensity (Visual Analog Scale, VAS), articular amplitude of shoulder movement (flexion, extension, abduction, adduction, medial rotation, lateral rotation), muscle strength (abduction, lateral rotation), and electromyography (lateral rotation, abduction). Treatments comprised 12 sessions for 4 weeks. Intra-group analysis showed that the five therapies significantly improved the recovery of all parameters after treatment. Regarding the comparison of irradiated therapies and ultrasound, statistical analysis showed that IR-US was a better treatment than US for all 12 parameters. IR treatment exceeded US on 9 items, whereas that VR and VR-US therapies exceeded US in 7 and 10 parameters, respectively (p < 0.05). Because of that, IR-US shows to be the best treatment for rotator cuff tendinopathy. In conclusion, improvements in quality of life, pain intensity relief, shoulder amplitude motion, and muscle strength force obtained with ultrasound therapy are enhanced by adding infrared LED irradiation to ultrasound for patients suffering from rotator cuff tendinopathy. This study was registered with the Brazilian Registry of Clinical Trials (ReBEC) under Universal Trial Number (UTN) U1111-1219–3594 (2018/22/08).

Ethylene oxide and gamma irradiation are two well-established sterilizing processes for surgical materials; however, they present toxicity and high cost, respectively. Ozone Gas, O_3(g), has been used effectively for disinfection and sterilization. Low pressure (LP) can promote water vaporization whenever the vapor pressure drops below the water saturation pressure, which at 20 °C (experimental temperature) is 2337 Pa. The microorganism used to contaminate the surgical needles (SN) was Staphylococcus aureus, a gram-positive bacterium whose cytoplasm is mostly water. Sixty SN samples were divided into six groups of 10: negative control (sterile SN), positive control (experimentally contaminated SN), LP group, two groups associating LP and O_3(g), and O_3(g) alone group. The CFU/mL count demonstrated microbicide efficacy of LP+O_3(g) and O_3(g) groups. This is an innovative protocol for microbial inactivation, mainly because of LP application. In the future, this technique can be evaluated for sterilization of SN and other medical devices.

Background: The analysis of the complete blood count (CBC) of patients with community-acquired pneumonia (CAP) is an essential practice both for diagnosing the disease and for evaluating the patient's clinical evolution. It is proposed in the present study to analyze the hematological alterations resulting from photobiostimulation using near-infrared light-emitting diodes (LEDs) in patients with CAP. Methods: This was a clinical, prospective, blinded, and descriptive longitudinal study that involved 21 patients undergoing CAP treatment who were divided into two groups: LED, 11 patients who were treated with infrared LED and conventional treatment; and CON (control), 10 patients who received only conventional treatment (antibiotic therapy and physiotherapy). Physiotherapy was applied before LED irradiation in the LED group. The patients' CBCs were obtained before and after treatment, and erythrocyte counts, hemoglobin and hematocrit concentrations, and leukocyte and platelet counts were assessed. The phototherapy was performed with a vest with an array of 300 LEDs (940 nm) mounted on an area of 36 × 58 cm and positioned in the patient's anterior thoracic and abdominal regions. The total power was 6 W, with 15 min of irradiation time. The patients were treated daily for seven consecutive days. Statistical analyses of the intra- and intergroups of CBC data were done using Student's t-test and one-way ANOVA (analysis of variance), respectively, both at the significance level of α = 0.05. Results: There was a statistically significant recovery difference after treatment in the LED group compared with the CON group for erythrocytes, hemoglobin, leukocytes, segmented and band neutrophils, lymphocytes, and monocytes (p < 0.05). The greatest differences between the LED and CON groups were lymphocyte count reduction (60% vs. 16%), erythrocyte increase (86% vs. 35%), and leukocyte reduction (28% vs. 15%). Conclusions: The hematologic components of CAP patients recovered their normal values faster with conventional treatment associated with infrared LED therapy, thus indicating greater treatment efficiency when compared with the conventional therapy. This study was registered with the Brazilian Registry of Clinical Trials (ReBeC) under Universal Trial Number (UTN) U1111-1229-1296 (2019/06/05).

Background: Published literature reports significant improvements in pathological conditions, such as pain, blood dyscrasias, and cellulite, after using topical occlusive accessories containing particulate ceramic materials. Objective: In this study, we investigated whether the use of a topical occluding garment made with synthetic fibers embedded with powdered ceramic materials could be beneficial to patients suffering from edema of lower limb extremities. Materials and methods: The cohort comprised 30 volunteers of both genders who were divided into two study groups. The bioceramic (BC) group wore compressive socks made of fabrics with embedded ceramic powder for 8 h a day for 28 days. The placebo group wore compressive socks of the same material without ceramic powder. The efficacy of the treatment was quantified through weekly plethysmographic measurements. In addition, pain relief was evaluated through a visual analog scale (VAS). Results: Data showed a statistically significant reduction in the edema volume for the BC group compared with the placebo group: 78.9 ± 10.7 mL versus 41.3 ± 5.6 mL, p = 0.003. Further, there was also greater pain relief for the BC group when compared with the placebo group, with a pain decrease of 7.0 ± 0.2 U versus 3.3 ± 0.2 U, respectively, on the VAS from 0 to 10 ( p = 0.024). Conclusions: The topical occlusive therapy with compressive socks containing infrared-emitting ceramic particulate in its fabrics showed that they were more beneficial than the placebo garment in the treatment of edema of the inferior member extremities as well as in relief of associated pain.