Abstract Purpose: To evaluate the in vivo response of photobiomodulation therapy associated with norbixin-based poly(hydroxybutyrate) membrane (PHB) in tenotomized calcaneal tendon. Methods: Thirty rats were randomly allocated to six groups (n=5 each): LED groups (L1, L2 and L3) and membrane + LED groups (ML1, ML2 and ML3). The right calcaneal tendons of all animals were sectioned transversely and were irradiated with LED daily, one hour after surgery every 24 hours, until the day of euthanasia. At the end of the experiments the tendons were removed for histological analysis. Results: The histological analysis showed a significant reduction in inflammatory cells in the ML1, ML2 and ML3 groups (p=0.0056, p=0.0018 and p<0.0001, respectively) compared to those in the LED group. There was greater proliferation of fibroblasts in the ML1 (p<0.0001) and L3 (p<0.0001) groups. A higher concentration of type I collagen was also observed in the ML1 group (p=0.0043) replacing type III collagen. Conclusion: Photobiomodulation in association with norbixin-based PHB membrane led to control of the inflammatory process. However, it did not favor fibroblast proliferation and did not optimize type I collagen formation in the expected stage of the repair process.

Abstract Purpose: To determine the efficacy of norbixin-based poly(hydroxybutyrate) (PHB) membranes for Achilles tendon repair. Methods: Thirty rats were submitted to total tenotomy surgery of the right Achilles tendon and divided into two groups (control and membrane; n = 15 each), which were further subdivided into three subgroups (days 7, 14, and 21; n = 5 each). Samples were analyzed histologically. Results: Histological analysis showed a significant reduction in inflammatory infiltrates on days 7, 14 (p < 0.0001 for both), and 21 (p = 0.0004) in the membrane group compared to that in the control group. There was also a significant decrease in the number of fibroblasts in the control group on days 7, 14 (p < 0.0001), and 21 (p = 0.0032). Further, an increase in type I collagen deposition was observed in the membrane group compared to that in the control group on days 7 (p = 0.0133) and 14 (p = 0.0107). Conclusion: Treatment with norbixin-based PHB membranes reduces the inflammatory response, increases fibroblast proliferation, and improves collagen production in the tendon repair region, especially between days 7 and 14.

RESUMO Objetivo: A necessidade em quantificar a dor e qualidade de vida (QV) é essencial para o profissional quanto a sua conduta terapêutica. O objetivo desta revisão é identificar os métodos de análise qualitativa e quantitativa da dor e QV validadas no Brasil. Métodos: Revisão realizada através das bases de dados LILACS, SciELO, MedLine e Google Acadêmico com os descritores: “métodos”, “análise qualitativa”, “análise quantitativa”, “dor” e “qualidade de vida”. Critérios de inclusão: Artigos publicados português e inglês no período compreendido entre 1996 a 2015. Critérios de exclusão: textos incompletos, artigos que não abordam a temática do estudo e repetição de um mesmo artigo nas bases de dados Resultados: Após aplicação dos critérios de elegibilidade foram selecionados 27 artigos para leitura, dos quais foi excluído um artigo por não apresentar resultado relevante e outro por repetição. Dos 25 artigos, um foi publicado em 2015, três em 2014, um em 2013, três em 2012, cinco em 2011, dois em 2010, três em 2009, quatro em 2008, dois em 2004 e um em 1996. Em relação aos estudos, nove são ensaios clínicos, 10 revisões sistemáticas cinco estudos transversais e uma dissertação. Conclusão: Os métodos mais utilizados são EVA, em caso de análise multidimensional da dor o mais citado é Questionário de McGill. O questionário para avaliação de QV mais utilizado é o SF-36. Existe uma grande dificuldade em classificar os métodos de avaliação da dor e QV (qualitativo ou quantitativo), uma vez que muitos autores citam o mesmo método abordando as duas interfaces.

ABSTRACT Objective: The need to quantify pain and quality of life (QoL) is essential for professionals considering their therapeutic approach. The goal of this review is to identify the methods to perform qualitative and quantitative analysis of pain and QoL validated in Brazil. Methods: Review by the LILACS, SciELO, MedLine and Google Scholar databases with the descriptors: methods, qualitative analysis, quantitative analysis, pain and quality of life. Inclusion criteria: articles published in Portuguese and in English in the period from 1996 to 2015. Exclusion criteria: incomplete texts, articles that did not address the subject of study and duplicate articles in the databases. Results: After applying the eligibility criteria, 27 articles were selected for reading, being that one article was excluded by presenting irrelevant result and another was excluded by duplication. From the 25 articles, one was published in 2015, three in 2014, one in 2013, three in 2012, five in 2011, two in 2010, three in 2009, four in 2008, two in 2004 and one in 1996. In relation to the studies, nine were clinical trials, 10 systematic reviews, five cross-sectional studies and one essay. Conclusion The most frequently methods applied are the VAS and the McGill’s Questionnaire, considering the multidimensional pain assessment. The most commonly used questionnaire to evaluate QoL is the SF-36. There is great difficulty to classify methods for assessing pain and QoL (qualitative or quantitative methods), since many authors report the same method when addressing the two interfaces.

Resumo Objetivo: Descrever o efeito da fotobiomodulação no tratamento de neuralgia pós-herpética em idosa. Relato de caso: Paciente do gênero feminino, 61 anos, 56kg, 1,67cm de altura, procurou o Centro de Laserterapia da Universidade do Vale do Paraíba, na cidade de São José dos Campos, SP, Brasil, no dia 27 de outubro de 2015. Diagnosticada com herpes zoster em 4 de setembro de 2015 com queixas de neuralgia intermitente no trajeto do nervo torácico longo e picos de dor intensa (nível 10, segundo escala analógica de dor). A fotobiomodulação foi realizada com irradiações pontuais do laser de baixa intensidade em 20 pontos ao redor do nervo acometido pelo herpesvírus, com uma distância de 2 cm de cada ponto. A irradiação foi realizada com o tempo de 20 segundos em cada ponto, ou seja, 3J/cm2 por ponto e energia total de 60 J. Sendo ao final do tratamento o nível de dor 0 e o padrão de sono normal (oito horas de sono). Conclusão: A fotobiomodulação tratou o desconforto álgico, melhorou a qualidade de vida da paciente e mostrou-se, por meio de suas vantagens, ser um tratamento efetivo, seguro e promissor, com grande potencial de se tornar a terapia de escolha em tais casos.

Abstract Objectives: to describe the effect of photobiomodulation therapy in the treatment of post-herpetic neuralgia in the elderly. Case report: a female patient, 61 years old, 56 kg, 1.67cm tall, sought treatment at the Laser Therapy Center of the Universidade do Vale do Paraíba, in the city of São José dos Campos, São Paulo, Brazil, on October 27, 2015. She had been diagnosed with herpes zoster on September 4, 2015 with complaints of intermittent neuralgia in the long thoracic nerve path and spikes of intense pain (level 10, according to the analogue pain scale). Photobiomodulation was performed with low intensity laser spot irradiations at 20 points around the herpesvirus nerve, with a distance of 2cm between each point. Irradiation was performed at each point after 20 seconds, with 3J/cm2 per point and total energy of 60 J. At the end of the treatment the pain level was 0 and the patient exhibited a normal sleep pattern (8 hours of sleep). Conclusions: Photobiomodulation treated painful discomfort, improved the quality of life of the patient and proved to be an effective, safe and promising treatment, with significant potential to become the therapy of choice in such cases.

RESUMO O objetivo do presente relato de caso é avaliar a associação entre a Massagem Facial (MF), Agulhamento a Seco (AS) e Terapia a Laser de Baixa Intensidade (TLBI) no tratamento da Disfunção Temporomandibular (DTM) de origem muscular. Paciente com DTM crônica foi submetida a 4 sessões de associação entre a MF, AS e TLBI. A avaliação inicial e final foi composta por exame clínico baseado nos Critérios diagnósticos de pesquisa para DTM (RDC - Research Diagnostic Criteria), quantificação da intensidade da dor por meio da Escala visual analógica de dor, mensuração dos movimentos mandibulares e análise eletromiográfica (EMG) dos músculos masseter e temporal. Na pós-terapia, foi observada a redução de 58% dos sítios dolorosos, da média (1,3) da intensidade de dor e aumento de 10 mm na abertura máxima, além da normalização dos sinais EMG. Conclui-se que, após a aplicação de protocolo de tratamento, houve a redução dos sítios dolorosos, ganho de amplitude dos movimentos mandibulares e normalização da atividade EMG.

ABSTRACT This case report aims to evaluate the treatment of Temporomandibular Disorder (TMD) of muscular origin by associating facial massage (FM), dry needling (DN), and low-level laser therapy (LLLT). The pre- and post-treatment evaluations consisted of clinical examinations based on the Research Diagnostic Criteria (RDC) for TMD, pain intensity quantification by means of the Visual Analog Scale (VAS), mandibular movement measurement, and electromyographic (EMG) analysis of the masseter and temporal muscles. Post-therapy assessment indicated a decrease in pain sites of 58%, in pain intensity mean (1.3), and an increase in the maximum aperture of 10 mm, in addition to normalization of EMG signals. We conclude that, after application of the treatment protocol, there was a decrease in painful sites, gain in amplitude of mandibular movements, and normalization of EMG activity.

Introduction Threshold doses of electromagnetic radiation can initiate necrosis and apoptosis in cells. The purpose of this study was to evaluate cellular apoptosis and necrosis immediately (t0) and 24 hours (t24) after irradiation with different doses of coherent light (laser) or non-coherent light (LED). Methods CHO-K1 lineage cells were irradiated with laser (810nm) or LED (945±20nm), with 24mW, contact area of 1cm2 and doses of 10, 20, 30, 40 and 50J/cm2 for 300, 660, 960, 1230 and 1620s, respectively, at both wavelengths. Cells were evaluated by fluorescence microscopy, differentiating viable, apoptotic and necrotic cells immediately and 24 hours after irradiation. Results The number of necrotic cells at t0 was higher in the LED 40 and 50J/cm2 groups (86±14 and 84±16% respectively, p <0.05), than in the 10 and 20J/cm2 laser (5±2 and 5±3%, p<0.05) and LED (5±3 and 4±1%, p<0.05) conditions. At t24, the LED 40J/cm2 (80±20%, p<0.05) group also showed more necrosis than the control and lower dose groups (laser 10, 20, and 30J/cm2 percentage of 6±4, 10±3 and 7±3%, p<0.05; LED 10 and 20J/cm2 percentage of 3±1 and 17±10%, p<0.05). A decrease in apoptotic cells was observed in the laser group with doses of 10, 40, and 50J/cm2 (6±4, 3±1 and 1±1% respectively, not significant), as well as in the LED 40J/cm2 (2±2%, not significant) group versus control. The cells had a higher percentage of apoptosis cells in the control group and with laser doses of 10 and 30J/cm2 (percentage of 20±1 and 20±4%, not significant), while only the LED 40J/cm2 (10±10%, not significant) had a lower percentage compared the control group. Conclusion Laser or LED stimulation promoted an increase in cell necrosis in a high energy density condition as characterized in a dose-dependent inhibition therapy. Laser or LED infrared irradiation in low doses (up to 20J/cm2) reduced the percentage of apoptosis in CHO-K1 cells, while high doses (30J/cm2) elevated apoptosis.

Abstract Introduction Envenomation by Bothrops snakes can produce local pain, edema, hemorrhage and myonecrosis. However, standard antivenom therapy is generally ineffective in neutralizing these effects so that alternative methods of treatment have been investigated. In experimental animals, low-level laser therapy (LLLT) attenuates the local effects of Bothrops venoms, but the benefits of LLLT on muscle function after envenomation are unclear. In this study, we examined the influence of LLLT on the contractile activity of mouse skeletal muscle injected with venom from Bothrops jararaca, the principal cause of snakebite in southeastern Brazil. Methods Twenty-seven male mice were used. Mice were injected with venom (40 μg in 50 μl) in the right anterior tibialis muscle, after which the muscle tendon was exposed, connected to an isometric transducer and subjected to a resting tension of 1 g. A bipolar electrode was attached to the tibial nerve for electrical stimulation. The mice were randomly allocated to five groups: A – Control (n = 3), B – Venom 3 h (n = 6), C – Venom 9 h (n = 6), D – Venom + Laser 3 h (n = 6), E – Venom + Laser 9 h (n = 6). Results The two groups that received LLLT post-venom showed improved muscle contraction and contracture in relation to muscle treated with venom alone. Conclusion These results indicate that LLLT can improve muscle function after damage induced by B. jararaca venom.

ABSTRACT PURPOSE: To evaluate in a macroscopic, histological and histomorphometric manner the healing process of cutaneous wounds in mice. METHODS: The sample consisted of 40 male mice and was divided in four groups: 1st group (control, n=10), 2nd group (High Frequency Generator - HF, the maximum amplitude range, 120s, n=10), 3rd group (AlGaInP Laser 660 nm, 30mW power, 5 J/cm2, applying scan mode, 120s, n=10) and 4thgroup (AlGaInP Laser 660 nm, 30 mW power, 8 J/cm2, applying scan mode, n=10). The surgical incision was made with an 8 mm diameter punch perpendicularly to the back of the animal. The statistical analysis was achieved by the statistical test One Way Anova post hoc Tukey Test and significance at p<0.05 in GraphPad Prism program. RESULTS: It was observed that in the acute phase the AlGaInP Laser at 5 J/cm2 provided a greater stimulus to healing, and both lasers were effective in the remodeling phase. CONCLUSION: The AlGaInP lasers from 5 J/cm2 to 8 J/cm2 showed better biomodulatory results in the acute and remodeling phases respectively, however, the HF was less effective than the laser, providing significant benefits only in the acute phase of tissue repair.

Introduction:Low-level laser therapy (LLLT) is effective in preventing fatigue and in stimulating the microcirculation and cellular activity. In this study, we examined the effect of LLLT on injured tibial muscle in vivo by assessing muscle function during fatigue.MethodsTwenty-four male mice were used. Each mouse received an injection of sterile 0.9% saline solution (50 µL) in the right tibialis anterior muscle, after which the tendon of the muscle was exposed, connected to an isometric transducer and subjected to a resting tension of 1 g. A bipolar electrode was attached to the tibial nerve for electrical stimulation. The mice were randomly allocated to one of two groups: G1 (control: 3 h – n=8 and 9 h – n=5) and G2 (treated with GaAlAs laser, λ660 nm, 35 mW, 0.6 J, 17 s: 3 h – n=6 and 9 h – n=5).ResultsIn G1 mice, the amplitude of the tetanic contracture in response to induced fatigue remained unchanged during six consecutive tetani. The amplitude of the tetanic contractions in response to electrical stimulation (4-8 mV) was also unchanged. These results indicated muscle intactness in response to the load imposed by tetanus. In G2 mice, there was an increase in the amplitude of contraction after 3 h and 9 h when compared to G1 at 83% tetanus.ConclusionThese results indicate that exposure of muscle to LLLT enhanced the contractile force and increased the resistance to muscle fatigue without causing morphological damage to cellular structures.

INTRODUÇÃO: O diabetes mellitus é uma condição sistêmica que pode causar retardo da resposta tecidual frente a uma lesão. Diversos estudos têm apontado o laser como importante ferramenta terapêutica para o auxílio do processo de reparo tecidual. Contudo, poucos estudos foram realizados com o emprego de LED (Light Emitting Diode). Assim, o objetivo deste trabalho foi analisar o efeito da terapia com LED (λ = 945 ± 20nm) de baixa intensidade sobre tecido epitelial de ratos diabéticos em processo de reparo. MÉTODOS: Para tal, foi realizada a indução de diabetes experimental em 20 ratos machos (Wistar), com administração de 40mg/kg, por via endovenosa, de mono-hidrato de aloxana diluído em solução tampão. Após 14 dias, os animais foram submetidos à incisão tecidual na região dorsal, seguida de sutura e divididos em grupo-controle (GI e GIII, 3 e 7 dias pós-lesão, respectivamente), e grupo-tratado com LED (GII e GIV, 3 e 7 dias pós-lesão, respectivamente). Os animais do grupo tratado (n = 10) foram irradiados de forma transcutânea, em duas sessões (30 minutos e 48 horas pós-lesão). RESULTADOS: O número de fibroblastos foi significativamente maior no GIV em relação ao GIII. CONCLUSÃO: Considerando o aumento do número de fibroblastos (análise quantitativa) e o adequado fechamento da lesão (análise qualitativa), pode-se concluir que houve um efeito positivo da terapia LED na região do infravermelho próximo sobre o processo de reparo, após 7 dias de lesão tecidual em animais diabéticos (GIV).

INTRODUCTION: Diabetes mellitus is a systemic condition that can cause delayed tissue response to injury. Several studies have demonstrated laser therapy as an important tool to aid the process of tissue repair. However, few studies have been conducted with the use of LED (Light Emitting Diode). OBJECTIVE: The objective of this study was to analyze the low intensity LED (λ = 945 ± 20 nm) therapy effect on epithelial tissue of diabetic rats in the healing process. METHODS: The induction of experimental diabetes was performed in 20 male rats (Wistar) with the intravenous administration of 40mg/kg of alloxan monohydrate diluted in buffer solution. After 14 days the animals underwent tissue incision in the dorsal region, followed by suture, and divided into control groups (GI and GIII, 3 and 7 days post-injury, respectively) and groups treated with LED (GII and GIV, 3 and 7 days post-injury, respectively). The treated groups (n = 10) were irradiated transcutaneously, in two sessions (30 minutes, 48 hours post-injury). RESULTS: The number of fibroblasts was significantly higher in GIV compared to GIII. CONCLUSION: Considering the increase of fibroblasts (quantitative analysis) and appropriate closing of the lesion (qualitative analysis), we conclude that LED therapy in the near infrared region causes a positive effect on healing process after 7 days in tissue injury in diabetic animals (GIV).

INTRODUÇÃO: Estudos têm demonstrado a efetividade do laser no infravermelho (IV) sobre a atividade musculoesquelética. Contudo, não foram observados estudos sobre os efeitos da radiação emitida por um LED (Light Emitting Diode) no IV sobre a atividade do músculo masseter (MM, importante músculo da mastigação), sendo este o objetivo do presente estudo. MÉTODOS: Participaram do estudo 10 voluntários, os quais foram analisados por eletromiografia (atividade muscular, força e tempo de fadiga) e nível de lactato sanguíneo (mmol/L) após terapia placebo, laser (GaAlAs, 780 nm) e LED (GaAlAs, 880 nm). Os sinais obtidos previamente antes de realizadas as terapias foram tidos como controle. Os parâmetros de irradiação (laser ou LED) foram: potência de saída de 0,02 W, densidade de energia de 4 J/cm², área do feixe de 0,2 cm². Foram irradiados 8 pontos sobre o MM, de forma perpendicular e transcutânea, com distância de 1 cm entre os pontos. RESULTADOS: A atividade muscular foi significativamente maior pós-terapia laser e LED em relação aos valores controle. Não foram encontradas diferenças significativas nos valores de força, tempos de fadiga e níveis de lactato sanguíneo pós-terapia placebo, laser ou LED, quando comparados aos valores controle. CONCLUSÃO: Os resultados obtidos no presente estudo sugerem a otimização da atividade muscular com uso de terapia laser ou LED, sem causar efeitos colaterais, como a elevação de força e aumento dos níveis de lactato.

INTRODUCTION: Studies have demonstrated the effectiveness of the infrared laser (IR) on the skelet al muscle activity. However, it was not found studies on the effects of radiation emitted by IR LED (Light Emitting Diode) on the activity of masseter muscle (MM, important muscle of mastication), the aim of the present study. METHODS: Ten volunteers were involved and their electromyography (muscle activity, strength and fatigue time) and blood lactate levels (mmol/L) were analyzed after placebo, laser (GaAlAs, 780 nm) and LED (GaAlAs, 880 nm) therapies. The signals obtained previously conducted before the therapies were taken as control. The irradiation parameters (laser or LED) were: output power of 0.02 W, energy density of 4 J/cm² and beam area of 0.2 cm². Eight points on the MM were irradiated in a perpendicular and transcutaneous form with a 1-cm distance between the points. RESULTS: Muscle activity was significantly higher after laser and LED therapies when compared to control. No significant differences were found in force, fatigue time and blood lactate levels after placebo therapy, laser or LED, when compared to control. CONCLUSION: The results suggest the optimization of muscle activity with the use of laser or LED therapy, without causing side effects such as the increase in the force and levels of lactate.

INTRODUCTION: Low-intensity laser (LILT) and LED therapy are indicated in repairing surgical incisions, which occur in cardiac surgery. One major concern in this case is the presence of metallic wire used for sternal sutures, its temperature may rise while using a laser or LED. This study aimed to analyze the tensiometric properties of the skin tissue with longitudinal incision and metallic wire implant used for sternal suture irradiated with LILT and LED. METHODS: Twenty-five subjects (Rattus norvegicus) were submitted to thoracic incision with implantation of metallic wire, and subsequently divided into five groups: GI (control group); GII (laser group 6J/cm²); GIII (laser group 10J/cm²); GIV (LED group 6 J/cm²); and GV (LED 10J/cm²). Photobiomodulation was performed on a daily basis for eight consecutive days and the local temperature was measured before and after phototherapy. After euthanasia the tissues were subjected to tensiometric and histological analysis. RESULTS: All irradiated groups showed increase in break strength (p = 0.009), and decrease in tissue deformation strength compared with the control group (p = 0.03). CONCLUSION: Both LILT and LED can promote wound healing at the tested doses with increased tissue resistance, although its elasticity is reduced. The imprecision of the assessing instruments precluded an accurate measurement of a possible local tissue heating post irradiation and future studies are need to elucidate this effect.

INTRODUÇÃO: Estudos demonstram que laserterapia pode melhorar o desempenho muscular e retardar o processo de fadiga muscular. Contudo poucos estudos referem-se à quantificação do desempenho por meio da biofotometria. O objetivo desse estudo é verificar os possíveis efeitos da fototerapia em relação a atividade e fadiga muscular. MÉTODOS: Foi realizado um ensaio clínico duplo-cego controlado randomizado com sete indivíduos adultos, atletas universitárias de voleibol feminino, saudáveis. A atividade muscular foi quantificada por meio da eletromiografia e os saltos pela biofotometria. A laserterapia (830nm, 30mW, 11J /ponto e 22 segundos) foi realizada no músculo tríceps sural a cada 3 cm² totalizando uma média de 20 pontos. Empregou-se o teste de Kolmogorov-Smirnov para análise da distribuição dos dados. RESULTADOS: Após o teste de normalidade o teste t-Student foi aplicado, considerando-se um nível de significância de 5% (p < 0,05). Não foi observada influência do laser em relação às variáveis estudadas. CONCLUSÃO: Apesar de muitos estudos demostrarem a correlação da fototerapia com a atividade muscular e fadiga, este estudo não apontou qualquer correlacão da laserterapia com a atividade e fadiga muscular.

INTRODUCTION: Studies show that laser therapy can increase muscle performance and delay the process of muscle fatigue. However, few studies have reported photogrammetry as a tool to analyze muscle performance. The objective of this study was to assess the possible effects of phototherapy in relation to activity and muscle fatigue. METHODS: We performed a crossover, randomized, double-blind, controlled trial with seven healthy female volleyball players. The muscle activities were quantified through electromyography, and jumps were quantified through photogrammetry Laser therapy (830 nm, 30 mW, 11 J per point and 22 seconds) was carried out on 3 cm² triceps surae muscle for an average of 20 points. The Kolmogorov-Smirnov test was used to analyze data distribution. RESULTS: After testing for normality, the Student t test was applied, considering a significance level of 5% (p <0.05). The laser had no effect with respect to the variables studied. Interestingly, a significant difference in motor recruitment values of the lateral gastrocnemius muscle was observed during plantarflexion movement. CONCLUSION: Although many studies have shown a correlation of phototherapy with muscle activity and fatigue, this study found no correlation of laser therapy with muscle activity or fatigue.

O objetivo do estudo foi revisar a literatura a respeito da terapia com laser de baixa potência e sua relação com as fases iniciais de reparo. Foram analisados 22 artigos, observando-se a utilização de diferentes doses e comprimentos de ondas (632,8 a 904 nm). Nos estudos in vitro, foram utilizadas doses entre 2,2 e 16 J/cm². A dose de 5 J/cm² tem sido apontada como responsável por mudanças significativas in vitro; porém, a dose de 16 J/cm² promove efeito inibitório sobre o crescimento celular em culturas. Em estudos in vivo, envolvendo animais, foram utilizadas doses entre 0,04 a 21 J/cm². Para estudos em humanos, foram utilizadas doses entre 1,8 a 16 J/cm². Conclui-se que a terapia com laser de baixa potência exerce efeitos anti-inflamatórios importantes nos processos iniciais da cicatrização: redução de mediadores químicos, de citocinas, do edema, diminuição da migração de células inflamatórias e incremento de fatores de crescimento, contribuindo diretamente para o processo de reabilitação tecidual. Porém, a falta de padronização dificulta a escolha de parâmetros ideais.

O objetivo do estudo foi realizar uma revisão de literatura a respeito da terapia com laser de baixa potência e sua relação com as fases iniciais de reparo. Foram analisados 22 artigos, observou-se a utilização de diferentes doses e comprimentos de ondas (632,8 a 904 nm). Nos estudos in vitro foram utilizadas doses entre 2,2 e 16 J/cm². A dose de 5 J/cm² tem sido apontada como responsável por mudanças significativas in vitro, porém a dose de 16 J/cm² promove efeito inibitório sobre o crescimento celular em culturas. Em estudos in vivo, envolvendo animais foram utilizadas doses entre 0,04 a 21 J/cm². Para estudos em humanos foram utilizadas doses entre 1,8 a 16 J/cm². Conclui-se que a terapia com laser de baixa potência exerce efeitos antiinflamatórios importantes nos processos iniciais da cicatrização: redução de mediadores químicos, de citocinas, do edema, diminuição da migração de células inflamatórias e incremento de fatores de crescimento contribuindo diretamente para o processo de reabilitação tecidual. Porém, a falta de padronização dificulta a escolha de parâmetros ideais.

A estruturação do Sistema Nacional de Vigilância Epidemiológica do Brasil, em 1975, tornou obrigatória a notificação de algumas doenças transmissíveis com o objetivo de reduzir a carga destes eventos no país. Entretanto, as alterações no perfil epidemiológico destas doenças, associadas a características da sociedade contemporânea, determinam a constante adequação das atividades de vigilância a este cenário. Neste manuscrito, são descritos epidemiologia, tendências e diagnóstico diferencial das seguintes doenças dermatológicas de notificação compulsória no Brasil: aids, dengue, hanseníase, leishmaniose tegumentar americana, sarampo, rubéola e síndrome da rubéola congênita e sífilis. Também são apresentados os principais desafios atuais para o controle e prevenção para cada uma dessas doenças no Brasil

The development of a Brazilian National Surveillance System in 1975 led to a compulsory reporting of selected infectious diseases aiming to reduce the burden of these events in the country. However, shifts in the epidemiology of these diseases associated with modern life style, demand constant revision of surveillance activities. In this manuscript we present the epidemiology, trends and differential diagnosis of the following compulsory notifiable diseases in Brazil: Aids, dengue fever, hanseniasis, American tegumentary leishmaniasis, measles, rubella and congenital rubella syndrome and syphilis. Additionally, the current challenges for control and prevention of each disease are presented