RESUMO
This study aimed to assess the effects of High-intensity laser therapy (HILT) on individuals suffering from temporomandibular joint disorders (TMDs). A search was conducted across six electronic databases for randomized controlled trials (RCTs) focusing on HILT for TMDs: PubMed, Scopus, Web of Science, ScienceDirect, EBSCOhost, Cochrane Library, the PEDro database and Google Scholar (last updated on July 18, 2024). Eligible studies were chosen by independent reviewers, and their quality was assessed with the Cochrane risk of bias tool (RoB). The main outcome was pain intensity (VAS), with secondary outcomes including mouth opening (mm), disability (JFLS-20), and quality of life (OHIP-14). A meta-analysis was conducted to assess the pooled effect by calculating mean differences (MD) for these variables (95% confidence level). The heterogeneity of the meta-analyses was explored using the I2 statistic. Three studies met the selection criteria and were included in the meta-analysis. The main RoB was the blinding of participant and treaters. Statistically significant differences (p < 0.05) in favor of HILT were observed for VAS and maximum mouth opening. The pooled effect showed an MD of -14.8 mm (95% CI:-27.1,-2.5) for pain intensity and 3.7 mm (95% CI:0.9,6.5) for mouth opening, changes that were assessed as clinically important. According to GRADE, the evidence was rated as important, and the certainty was moderate due to the heterogeneity between studies. A sensitivity analysis was not performed to address heterogeneity, primarily due to the limited availability of RCTs. HILT has been found effective in short-term pain relief and improvement of jaw opening in TMDs, potentially enhancing quality of life by facilitating activities such as chewing, jaw mobility, and communication. However, further research is needed to confirm its long-term effectiveness. Combining HILT with interventions such as occlusal splints or therapeutic exercises could potentially enhance its effects, leveraging the existing evidence supporting these treatments. It is important to note that the high RoB associated with the lack of blinding of participants and treaters may influence data collection, compromising the internal validity of findings in some studies.
Assuntos
Transtornos da Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/radioterapia , Transtornos da Articulação Temporomandibular/terapia , Resultado do Tratamento , Qualidade de Vida , Terapia a Laser/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição da DorRESUMO
The purpose of this systematic review was to evaluate the effects of high-intensity laser therapy (HILT) on pain, disability, and range of movement in patients with neck pain. Randomized controlled trials (RCTs) of HILT for neck pain disorders were searched across databases such as PubMed, Web of Science, Scopus, CINAHL, Science Direct, Cochrane Library, the PEDro database, and Google Scholar (updated January 7, 2024). The main outcome was pain intensity, with neck disability and cervical range of motion as secondary outcomes. Researchers reviewed article titles and abstracts from different databases using the Rayyan web app. Study quality was assessed using the Cochrane risk of bias tool, and evidence-based recommendations were developed using the GRADE approach. A meta-analysis was conducted to calculate the pooled effect in terms of mean differences (MD) for the outcomes of interest, along with a 95% confidence interval (95% CI). Twenty studies met the selection criteria and were potentially eligible for inclusion in the meta-analysis. At the end of the treatment, there was a statistically significant (p < 0.01) pooled MD of -14.1 mm for pain intensity (17 RCTs) with the VAS (95% CI:-18.4,-9.7), 3.9° (95% CI:1.9,6.7) for cervical extension (9 RCTs), and -8.3% (95% CI:-14.1,-4.1) for disability diminish (12 RCTs) with the neck disability index in favor of HILT. Only the results for pain intensity are in line with the minimal clinically important differences (MCID) reported in the literature. Overall, the evidence was deemed significant but with low certainty, attributed to observed heterogeneity and some risk of bias among the RCTs. HILT demonstrates effectiveness in reducing neck pain and disability while enhancing cervical extension when added to other physical therapy interventions, especially therapeutic exercise, based on a moderate level of evidence. This review highlights that the most favorable results are obtained when HILT is employed to address myofascial pain, cervical radiculopathy and chronic neck pain.PROSPERO registration number: CRD42023387394 (Registration date, 14/01/2023).
Assuntos
Cervicalgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Cervicalgia/radioterapia , Cervicalgia/terapia , Terapia a Laser/métodos , Resultado do Tratamento , Amplitude de Movimento Articular , Medição da DorRESUMO
The purpose of this study is to evaluate the effects of high-intensity laser therapy (HILT) in patients with frozen shoulder. PRISMA guidelines were adhered to, and a systematic search was conducted in the PubMed, Web of Science, Scopus, CINAHL, Science Direct, and PEDro databases (last update: September 4, 2023; search period: December 2022-September 2023). The inclusion criteria encompassed RCTs comparing HILT with other physical therapy interventions in frozen patients with frozen shoulders, with or without sham HILT, assessing pain intensity, shoulder ROM, and disability outcomes. The quality of the RCTs was assessed with the Cochrane Risk of Bias tool, and evidence was assessed using the GRADE approach. Five trials met the eligibility criteria and were included in the review and meta-analysis, which pooled results from the visual analog scale (VAS), goniometry, and the shoulder pain and disability index (SPADI). Mean differences (MDs) for pain intensity and disability show a pooled effect in favor of HILT both for VAS (MD = - 2.23 cm, 95% CI: - 3.25, - 1.22) and SPADI (MD = - 10.1% (95% CI = - 16.5, - 3.7), changes that are statistical (p < 0.01) and clinical. The MD for flexion (MD = 9.0°; 95% CI: - 2.36°, 20.3°; p = 0.12), abduction (MD = 3.4°; 95% CI: - 6.9°, 13.7°; p = 0.51), and external rotation (MD = - 0.95°; 95% CI: - 5.36°, 3.5°; p = 0.67) does not show statistical and clinical differences between groups after treatment. PI and disability changes were graded as important due to their clinical and statistical results. HILT into a physical therapy plan reduce pain and disability, but it does not outperform conventional physical therapy in improving shoulder ROM. It is suggested that future RCTs compare the effects of HILT and LLLT to assess their possible differences in their analgesic effects.
Assuntos
Bursite , Terapia a Laser , Terapia com Luz de Baixa Intensidade , Humanos , Bursite/radioterapia , Modalidades de Fisioterapia , Dor de Ombro/radioterapiaRESUMO
Resumen Objetivos: El estudio pretende reconocer la existencia de agentes portadores y reproductores de prácticas y saberes populares en salud, sus dominios y dinámica en el espacio social. Georreferenciar sus dinámicas y establecer su relación con el Plan Básico de Ordenamiento Territorial. Metodología: Estudio cualitativo analítico, que conjuga la geografía crítica y la etnografía. Mediante el uso de técnicas de georreferenciación, -localización y espacialización-, con uso del software QGIS versión 3.6 Nossa. Y mediante el uso de técnicas de entrevistas a profundidad y observaciones documentadas, información que se ordenó y sistematizó por categorías, mediante la implementación del programa ATLAS.ti versión 9. Resultados: Se reconocieron más de 60 agentes y se localizaron 48. Se reconocen dos dominios del saber popular: el mágico religioso, expresado en sobanderos con secreto, y el curanderismo expresado en hierbateros, rezanderos y sobanderos. Se legitiman a través de su presencia en espacios sociales, en sus tres dimensiones: material, al portar una identidad y un dominio, que habitan con objetos; mental, el cual cargan de relaciones y simbolismos; y político, donde reproducen una cadena comercial vinculada a la zona de vocación comercial establecida por el PBOT del municipio. Conclusiones: Los agentes, sus prácticas y saberes se determinan y legitiman, a partir de actos de reproducción social, cultural y política en el territorio como espacio social, y en sus dimensiones, a partir de expresiones culturales, simbolismos y rituales, relaciones materiales a partir del intercambio con objetos y servicios, y su asiento político en las zonas de vocación territorial.
Abstract Objectives: The study aims at recognizing the existence of agents carrying and reproducing popular practices and knowledge in health, their domains and dynamics in the social space and at geo-positioning their dynamics and establishing their relationship with the Basic Plan of Territorial Planning. Methodology: qualitative analytical study that combines critical geography through georeferencing techniques, -localization and spatialization-, using the QGIS Version 3.6 Nossa program, and ethnography through the use of in-depth interview techniques and observations, information that was organized and systematized by categories through the implementation of the ATLAS.ti version 9 program. Results: More than 60 agents were recognized and 48 were located. Two domains of popular knowledge were recognized: the Religious Magic, expressed in massage therapists (sobanderos) with secrecy, and folk medicine (Curanderismo) expressed in shamans, rezanderos and sobanderos. They are legitimized through their presence in social spaces in their 3 dimensions: material by carrying an identity and a domain inhabiting objects; mental which is loaded with relationships and symbolism; and political where they reproduce an overlapping and expanded commercial chain, linked to the area of commercial vocation delimited by the PBOT of the municipality. Conclusions: Agents, their practices and knowledge are determined and legitimized based on acts of social, cultural and political reproduction in the territory as a social space, and in their dimensions based on cultural expressions, symbolisms and rituals, material relationships from the exchange with objects and services and settled politically in the areas of territorial vocation.
Resumo Objetivos: o estudo pretende reconhecer a existência de agentes portadores e reprodutores de práticas e saberes populares em saúde, seus domínios e dinâmica no espaço social. Georreferenciar suas dinâmicas e estabelecer sua relação com o Plano Básico de Ordenamento Territorial. Metodologia: estudo qualitativa analítico, que conjuga a geografia crítica e a etnografia. Através do uso de técnicas de georreferenciação, -localização e espacialização-, com uso do software QGIS versão 3.6 Nossa. E através do uso de técnicas de entrevistas a profundidade e observações documentadas, informação que se arrumou e sistematizou por categorias, através da execução do programa ATLAS.ti versão 9. Resultados: reconhecerem-se mais de 60 agentes e se localizaram 48. Reconhecem-se dois domínios do saber popular: o mágico religioso, expressado em sobanderos (pessoa que sana a través de massagens) com secreto, e o curandeirismo expressado em curandeiros, rezanderos (pessoa que sana a través da oração) e sobanderos. Legitimam-se através de sua presença em espaços sociais, em suas três dimensões: material, ao trazer uma identidade e um domínio, que habitam com objetos; mental, o qual carregam de relaciones e simbolismos; e político, onde reproduzem uma cadeia comercial vinculada à zona de vocação comercial estabelecida pelo PBOT do município. Conclusões: os agentes, suas práticas e saberes se determinam e legitimam, a partir de atos de reprodução social, cultural e política no território como espaço social, e em suas dimensões, a partir de expressões culturais, simbolismos e rituais, relações materiais a partir do intercâmbio com objetos e serviços, e sua posição política nas zonas de vocação territorial.
RESUMO
Introducción: revalorizar y resignificar la identidad de los saberes tradicionales en salud es retador, en una cultura mediada por la industrialización, perviviendo con un pasado histórico, patrimonial cultural y simbólico, desde una identidad mixturada que se conjuga en un sincretismo territorial, que persiste a través de huellas físicas y culturales de tradiciones mágico religiosas. Objetivo: reconocer las particularidades etnográficas de los agentes portadores de saberes populares en salud que les permite afianzar sus prácticas en el municipio de Andes- Antioquia. Y resignificar estas prácticas para recuperar sus entornos identitarios y rituales simbólicos, en la configuración de su identidad como cuerpo orgánico en los espacios sociales. Metodología: investigación cualitativa, de tipo descriptivo, con perspectiva etnográfica (microetnográfica), sistematizada a través de entrevistas a profundidad acompañadas de registros fotográficos y observaciones participantes. Resultados: se reconocen 48 agentes sociales entre 30 y 70 años, la mayoría asentados en la ruralidad. Entre ellos: sobanderos con secreto, sobanderos con dolor o componedores, hierbateros y rezanderos. Se reconoce su identidad diversa desde una emergencia mágica religiosa y se exponen las características de sus saberes heredados, en una ritualidad envolvente que los recrea y vitaliza en los espacios sociales. Discusión: se analizan los resultados en el marco del espacio social, multidimensional y complejo, a través de sus tres elementos: estructuras sociales, relaciones sociales y formas espaciales. Conclusiones: las formas espaciales trasladan el simbolismo al espacio social físico con características que afianzan el ejercicio de su saber y su identidad. La brecha entre los conocimientos occidentales y los saberes tradicionales se cierra cada vez más por la fuerza de sus realidades en la vida cotidiana, de una sociedad globalizada.
Introduction: revaluing and re-signifying the identity of traditional health knowledge is challenging in a culture mediated by industrialization, surviving with a historical past, cultural and symbolic heritage, from a mixed identity that is conjugated in a territorial syncretism, which persists through physical and cultural traces of magical-religious traditions. Objective: to recognize the ethnographic particularities of the agents who carry popular knowledge in health that allows them to strengthen their practices in the Andes-Antioquia municipality. To re-signify these practices to recover their identity and symbolic ritual environments, in the configuration of their identity as an organic body in social spaces. Methodology: qualitative, descriptive type research, with ethnographic perspective (micro-ethnographic), systematized through in-depth interviews, accompanied by photographic records and participant observations. Results: 48 social agents between 30 and 70 years old, most of them settled in rural areas, were identified. Among them: sobanderos with secret, sobanderos with pain or componedores, hierbateros and rezanderos. Their diverse identity is recognized from a magical religious emergence and the characteristics of their inherited knowledge are exposed, in an enveloping rituality that recreates and vitalizes them in social spaces. Discussion: the results are analyzed within the framework of social, multidimensional and complex spaces, through its three elements: social structures, social relations and spatial forms. Conclusions: spatial forms transfer symbolism to the physical social space with characteristics that strengthen the exercise of their knowledge and identity. The gap between western knowledge and traditional knowledge is closing more and more due to the strength of its realities in the daily life of a globalized society.
Introdução: revalorizar e resignificar a identidade dos conhecimentos tradicionais em saúde é um desafio em uma cultura mediada pela industrialização, sobrevivendo com um passado histórico, cultural e simbólico, a partir de uma identidade mista de sincretismo territorial, que persiste através de traços físicos e culturais de tradições mágico-religiosas. Objetivo: reconhecer as particularidades etnográficas dos agentes portadores de conhecimentos populares em saúde que lhes permitam fortalecer suas práticas no município de Andes, Antioquia. E resignificar estas práticas a fim de recuperar seus espaços de identidade e rituais simbólicos, na configuração de sua identidade como um corpo orgânico em espaços sociais. Metodologia: pesquisa qualitativa, descritiva, com uma perspectiva etnográfica (microetnográfica), sistematizada através de entrevistas em profundidade acompanhadas de registros fotográficos e observações dos participantes. Resultados: Foram identificados 48 agentes sociais entre 30 e 70 anos de idade, a maioria deles instalados em áreas rurais. Entre eles: sobanderos com secreto, sobanderos com dor ou componedores, herboristas e curandeiros. Sua identidade diversificada é reconhecida a partir de uma emergência mágica religiosa e as características de seus conhecimentos herdados são expostas, em um ritual envolvente que os recria e os vitaliza nos espaços sociais. Discussão: os resultados são analisados no âmbito do espaço social, multidimensional e complexo, através de seus três elementos: estruturas sociais, relações sociais e formas espaciais. Conclusões: As formas espaciais traduzem o simbolismo em espaço social físico com características que fortalecem o exercício de seu conhecimento e identidade. A distância entre o conhecimento ocidental e o conhecimento tradicional está se fechando cada vez mais devido à força de suas realidades na vida cotidiana em uma sociedade globalizada.
Assuntos
Humanos , Masculino , Feminino , Etnobotânica , Terapias Espirituais , Medicina Tradicional , Antropologia CulturalRESUMO
El linfoma de células T epidermotropo agresivo CD8+ o linfoma de Berti es un subtipo infrecuente de los linfomas primarios cutáneos, descripto en 1999. Aún se considera una entidad provisional en la última clasificación de linfomas cutáneos primarios de la Organización Mundial de la Salud. Predomina en los hombres adultos y se manifiesta con pápulas, placas hiperqueratósicas y tumores ulcerados, diseminados y de inicio agudo. En la histopatología, es característica la presencia de un infiltrado de linfocitos atípicos medianos CD8 +, con epidermotropismo de patrón pagetoide. Tiene un comportamiento agresivo y es de mal pronóstico, con una sobrevida a los 5 años menor del 40%. Si bien esta entidad es un reto terapéutico, el tratamiento inicial se basa en poliquimioterapia y/o trasplante de células hematopoyéticas.
The aggressive epidermotropic CD8+ T-cell lymphoma or Berti's lymphoma, is a rare subtype of primary cutaneous lymphomas, first described in 1999. It is still considered a provisional entity by the latest World Health Organization classification of cutaneous lymphomas. Patients are commonly adults with a male predominance and it is characterized by widespread rapid evolving papules, hyperkeratotic annular plaques and ulcerated tumors. Histopathologicfindingsarecharacteristic,withaninfiltrate of medium-sized CD8+ atypical lymphocytes involving the epidermis with a pagetoid pattern. Ithasanaggressivebehaviorandtheprognosisispoor with a 5-yearsurvival less than 40%. Instead these disease represents a therapeutic challenge, the initial treatment consists on polychemotherapy and hematopoietic stem cell transplantation.
Assuntos
Humanos , Neoplasias Cutâneas , Linfoma Anaplásico Cutâneo Primário de Células Grandes/diagnóstico , Carcinoma de Células Escamosas , Quimioterapia Combinada , Linfoma Anaplásico Cutâneo Primário de Células Grandes/terapiaRESUMO
Putre Ìs oregano (Origanum vulgare L.) is a variety of oregano that grown in the Arica-Parinacota Region. Its organoleptic attributes and unique production conditions have earned it a certification with Geographical Indication (GI). However, the demands of the markets require a scientific-technological support for identification and authentication of materials. In this context, was proposed to identify Putre's oregano by phylogenetic relationships based on the use of molecular markers SSR and "DNA Barcode". The results showed that when comparing materials from different sources of Putre Ìs oregano versus information from certified germplasms and GenBank sequences, added to the analysis with nuclear genetic markers, Putre Ìs oregano corresponds to the species Origanum vulgare L. subsp virens. This precise identification will support the correct differentiation and authentication of this genotype, serving in addition to supporting the GI.
El orégano de Putre (Origanum vulgare L.) es una variedad de orégano que se cultiva en la Región de Arica y Parinacota. Sus atributos organolépticos y condiciones únicas de producción lo han hecho acreedor de una certificación con Indicación Geográfica (IG). Sin embargo, las exigencias de los mercados requieren de un respaldo científico-tecnológico de identificación y autenticación de materiales. En este contexto, se propuso identificar el orégano de Putre mediante relaciones filogenéticas a partir del uso de marcadores moleculares SSR y "DNA Barcode". Los resultados demostraron que al comparar los materiales de distintas procedencias de orégano de Putre versus la información desde germoplasmas certificados y secuencias de GenBank, sumado al análisis con marcadores genéticos nucleares, el orégano de Putre corresponde a la especie Origanum vulgare L. subsp virens. Esta identificación precisa dará soporte a la correcta diferenciación y autenticación de este genotipo, sirviendo además de apoyo a la IG.
Assuntos
Repetições de Microssatélites , Origanum/genética , Código de Barras de DNA Taxonômico , Filogenia , ChileRESUMO
El síndrome de Sézary (SS) es una rara y agresiva variante leucémica del linfoma cutáneo de células T, de pronóstico ominoso. Se caracteriza por presentar la tríada eritrodermia, linfadenopatías y linfocitos T neoplásicos circulantes. El diagnóstico está dado por la clínica, el estudio histopatológico, la citometría de flujo y el reordenamiento genético del receptor del linfocito T. En esta revisión se analizan la presentación clínica, la histopatología, el diagnóstico y el pronóstico de este síndrome. (AU)
Sézary syndrome (SS) is a rare and aggressive leukemic cutaneous T-cell lymphoma with poor prognosis. Is characterized by a triad of erythroderma, lymphadenopathy and circulating neoplastic T cells. Diagnosis is made by clinical features, histopathology, flow cytometry and T-cell receptor gene rearrangements. In this review we will analyze clinical presentation, histopathology, diagnosis and prognosis of SS. (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Síndrome de Sézary/diagnóstico , Prognóstico , Micose Fungoide/diagnóstico , Dermatite/diagnóstico , Diagnóstico DiferencialRESUMO
Pulmonary exacerbations of infectious cause are one of the major complications in patients with cystic fibrosis (CF). These are associated with a progressive increase in morbidity and mortality. The treatment depending on the isolated microorganism. The ß-lactam antibiotics are generally used which are not exempt from adverse reactions. Next, two report of neutropenia cases are described after prolonged use of cefepime in CF patients.