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Ação da terapia fotodinâmica antimicrobiana na descontaminação da membrana de celulose bacteriana utilizada em tratamento de queimaduras

Wed, 03 Jun 2026 00:00:00 GMT

Título: Ação da terapia fotodinâmica antimicrobiana na descontaminação da membrana de celulose bacteriana utilizada em tratamento de queimaduras Autor: Lima, Shirlene de Holanda Primeiro orientador: Prates, Renato Araujo Abstract: Burn injuries are complex lesions that compromise the integrity of the skin barrier, favoring colonization by opportunistic microorganisms such as Candida albicans, which may impair the healing process and reduce the effectiveness of conventional antimicrobial therapies. Among the biomaterials used in burn treatment, bacterial cellulose membranes (BCM) stand out due to their high biocompatibility, excellent water-retention capacity, and ability to maintain a moist microenvironment favorable for tissue regeneration. However, their susceptibility to microbial contamination highlights the need for decontamination strategies capable of preserving their functional properties. In this context, Antimicrobial Photodynamic Therapy (aPDT) has emerged as a promising alternative based on the photoactivation of a photosensitizer (PS), generating reactive oxygen species with broad-spectrum antimicrobial activity, low cytotoxicity, and minimal risk of inducing microbial resistance. This study aimed to evaluate the efficacy of aPDT in the decontamination of bacterial cellulose membranes experimentally contaminated with C. albicans (ATCC 90028), assessing the interaction between the photosensitizer and the biomaterial, the reduction of microbial viability, and the biomechanical properties of the membranes following treatment. Initially, photosensitizer incorporation into the BCM was evaluated through spectrophotometric analysis at different experimental time points. Subsequently, post-treatment microbiological quantification was performed by colony-forming unit (CFU/mL) counting to determine the antimicrobial efficacy of aPDT. Finally, tensile mechanical tests were conducted to evaluate maximum force per area and deformation per area of the membranes. The results demonstrated an immediate interaction between the photosensitizer and the BCM, with a stable behavior maintained throughout the experimental period. Microbiological analysis revealed a significant reduction in the viability of C. albicans following aPDT application, confirming the effectiveness of the decontamination strategy. Biomechanical assays showed no statistically significant differences between the evaluated groups, indicating preservation of the membrane's mechanical properties after treatment. In conclusion, aPDT represents a safe and effective strategy for the decontamination of bacterial cellulose membranes, combining stable photosensitizer–biomaterial interaction, significant reduction in microbial viability, and preservation of the membrane's biomechanical properties. These findings reinforce its potential for future applications in burn treatment. Keywords: Antimicrobial Photodynamic Therapy; Candida albicans; Bacterial Cellulose Membrane; Burns; Methylene Blue; Microbial Decontamination. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação

Impacto da fotobiomodulação com dispositivo de led de uso domiciliar na reabilitação de fraturas de úmero proximal: estudo clínico controlado randomizado duplo cego

Wed, 03 Dec 2025 00:00:00 GMT

Título: Impacto da fotobiomodulação com dispositivo de led de uso domiciliar na reabilitação de fraturas de úmero proximal: estudo clínico controlado randomizado duplo cego Autor: Freitas, Luiz Cláudio de Primeiro orientador: Ferrari, Raquel Agnelli Mesquita Abstract: Pain and joint stiffness are frequent complications after proximal humerus fractures (PHF), resulting in important functional limitation. Photobiomodulation (PBM) has shown benefits in fracture rehabilitation. This double-blind, randomized clinical trial evaluated the effects of PBM on the functional recovery of surgically treated PHF. Forty-two participants were randomized (1:1) into a Control group (physiotherapy + simulated PBM) and a PBM group (physiotherapy + active PBM). PBM was applied daily at home for 10 minutes using a device with 318 LEDs (159 LEDs at 660 nm: 28.5 mW, 12 J/cm², 17 J; and 159 LEDs at 850 nm: 23 mW, 10 J/cm², 14 J). PBM and physiotherapy sessions were conducted for 12 weeks. Participants and evaluators remained blinded to allocation, and assessments occurred at 24 h, 1, 2, 4, 8, and 12 weeks after surgery and daily through telephone contact. The primary outcome was shoulder function (QuickDASH). Secondary outcomes included range of motion, muscle strength, pain, analgesic consumption, quality of life (SF-6D), bone consolidation, occurrence of adverse events, and cost-effectiveness. Disability (QuickDASH) decreased over time in both groups, with a more pronounced reduction in the PBM group, although without significant interaction. There were no differences between groups in the evolution of range of motion, except for medial rotation, which showed lower values in the PBM group when comparing weeks 2, 8, and 12 versus day 1, without significant interaction. The PBM group showed fewer days with pain at weeks 8 and 12, with significant group–time interaction. Functional pain intensity showed significant interaction at weeks 4, 8, and 12, with lower intensity in the PBM group at week 12. For nighttime pain, there was significant interaction at week 12, with reduction in the PBM group and increase in the control. Both groups presented a progressive increase in pressure tolerated until the sensation of pain, without differences or significant interaction. Dipyrone consumption (days and tablets) showed significant interaction at weeks 8 and 12, with an increase in the control and lower values in the PBM group; this group also showed a lower mean number of days of dipyrone use. Tramadol use showed no differences or significant interactions. The SF-6D showed significant interactions at weeks 8 and 12, with a trend toward improvement in the PBM group. No differences were observed between groups in bone consolidation or muscle strength, and no adverse events related to PBM were reported. In the cost-effectiveness analysis, PBM demonstrated greater mean effectiveness in reducing QuickDASH scores and days with pain, although associated with incremental cost. PBM proved to be safe and associated with improvements in important clinical parameters, especially in reducing pain and dipyrone consumption between weeks 8 and 12, in addition to a trend toward improved quality of life. Although it did not alter global function, range of motion, muscle strength, or bone consolidation and generated financial increment, its analgesic effects suggest usefulness as an adjuvant to physiotherapy in the postoperative recovery of surgically treated PHF, indicating that PBM incorporation should simultaneously consider clinical gain and cost. Instituição: Universidade Nove de Julho Tipo do documento: Tese

Longo Covid-19: avaliação e comparação da qualidade de vida, sarcopenia e proteinúria em pacientes que tiveram apresentação clínica leve e moderada

Thu, 14 Dec 2023 00:00:00 GMT

Título: Longo Covid-19: avaliação e comparação da qualidade de vida, sarcopenia e proteinúria em pacientes que tiveram apresentação clínica leve e moderada Autor: Montenegro, Sayane Marlla Silva Leite Primeiro orientador: Dalboni, Maria Aparecida Abstract: The pandemic caused by the coronavirus (SARS-CoV-2) called COVID-19, was responsible for high hospitalization and mortality rates. Patients recovered from COVID-19 (long COVID-19), especially those who were admitted to the ICU, report tiredness, dyspnea, muscle pain; which are associated with worse quality of life. However, there are few reports evaluating long COVID-19 in its sequelae regarding quality of life, sarcopenia and proteinuria in individuals with mild and moderate clinical presentation. Objective: To evaluate and compare quality of life, sarcopenia and proteinuria in patients with long COVID-19 according to mild and moderate clinical presentation. Methods: Quantitative and longitudinal study. We evaluated 253 individuals with mild (n=119) and moderate (n=134) clinical presentation for COVID-19 (positive RT-PCR) after 6 (T6) and 12 (T12) months from the date of acute infection. Quality of life was assessed using the Short Form 36 (SF – 36) questionnaire, pain using the visual analogue scale (VAS), risk of sarcopenia using the Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC-F), functionality using the Dominant Palm Grip Strength (HGS), Sit – Up (sit and stand), and with the aid of the Duke Activity Status Index Questionnaire (DASI) and proteinuria using a urinalysis strip. Results: The average age was 44±10 and 43±12 years; female 68% and 59% for the mild and moderate groups, respectively. 75% or more of patients were vaccinated with at least 2 doses before acquiring COVID-19 infection. Individuals with a moderate clinical presentation in relation to mild cases were: hypertensive (23% and 6%, p < 0.001) and with diabetes mellitus (9% and 2%; p = 0.01) at the time of COVID-19 infection. The moderate group showed a statistically significant difference at T6: lower functional capacity (SF36: 46±20 vs. 61±24); more pain (SF36: 45±29 vs. 67±32 and VAS: 55% vs. 32%); greater dysfunctionality for daily activities (DASI: 40±11 vs. 45±10); lower number of repetitions for lower limb muscle strength (Sit-up: 9±2 vs. 11±2); higher sarcopenia score (SARC-F: 6±4 vs. 4±3) and higher proteinuria ≥1”+”: 59% vs. 42%) compared to the mild group. After 12 months, the moderate group remained with greater pain (SF36+VAS) and more dysfunctionality in daily activities (DASI) compared to the mild group. Comparing T12 to T6, we observed that the mild group had worse functional capacity; more pain (SF36+VAS); lower FPP and higher proteinuria ≥1”+”: 63% vs. 42%). The moderate group had lower HGS; greater 10 number of repetitions for the Sit-up at T12 compared to T6. We observed that individuals who had a higher SARC-F score showed a negative correlation with upper limb strength (Handgrip/FPP); lower limbs (Sit-up); functional capacity (SF36); dysfunction for daily activities (DASI). Conclusion: our results show that individuals who had mild and moderate presentation at the time of COVID-19 infection had long-term COVID-19 sequelae. However, the moderate group had greater pain sequelae at T6 and T12 and a greater risk of sarcopenia after 6 months, reduced muscle strength, which may contribute to a worse quality of life for these individuals. Furthermore, the presence of proteinuria for both groups is a warning to evaluate renal function; through other biomarkers to determine whether this proteinuria is transient or whether the infection caused by SARS-CoV-2 may be a risk factor for loss of kidney function and progression of kidney disease. Therefore, it is necessary to develop strategies for physical rehabilitation and follow-up assessment of renal filtration function in this population. Instituição: Universidade Nove de Julho Tipo do documento: Tese

Efeitos do treinamento em ergômetro de braço na pressão arterial ambulatorial em pacientes com doença arterial periférica

Tue, 13 Jun 2023 00:00:00 GMT

Título: Efeitos do treinamento em ergômetro de braço na pressão arterial ambulatorial em pacientes com doença arterial periférica Autor: Costa, Renan Massena Primeiro orientador: Correia, Marilia de Almeida Abstract: Patients with peripheral artery disease (PAD) are at high risk of fatal and non-fatal cardiovascular events. Strategies that help reduce cardiovascular risk in these patients are necessary to improve the health and quality of life of these patients. Studies with arm crank (AC) training have shown benefits in the functional capacity of patients with PAD, bypassing the main barrier to exercising in these patients, pain. However, the effect of this type of training on indicators of cardiovascular function, such as ambulatory blood pressure, is not yet established. Therefore, the aim of the present study was to analyze the effects of AC training on ambulatory blood pressure in patients with PAD and to compare it with the current exercise recommendation, walking training (WT). In this randomized controlled clinical trial, patients were randomly allocated into three experimental groups: AC training, WT and control group (CG). The AC and WT groups performed two weekly sessions with an intensity equivalent to 13-15 on the Borg subjective perception of exertion scale. Patients in the CG attended twice a week just to carry out various activities and socializing in a group, with no exercise involved. In addition, all groups were encouraged to increase their level of physical activity, which is usually the guideline in clinical management. Prior to the start and after 12 weeks of intervention, the following indicators of ambulatory blood pressure systolic (SBP), mean (MAP) and diastolic (DBP) were obtained: 24-hour mean, waking period, sleeping period, morning rise, nocturnal pressure load and mean real variability. For the analysis, the generalized estimation equations were used, having as factors the groups (AC, WT and CG) and the times (pre and post-intervention) and P <0.05 as significance. All groups started from the same ambulatory blood pressure values. After 12 weeks, it was possible to observe an interaction effect on the 24-hour DBP with a post hoc effect only on the AC [pre 78 (10) vs. powder 72 (5) mmHg, p=0.005]; in the MAP of wakefulness in [AC: pre 94 (11) vs. post 96 (11), p=0.044] and [WT: pre 94 (11) vs. post 96 (11) mmHg, p=0.044]; in wakefulness DBP of the AC group [pre 81 (11) vs. powder 76 (14) mmHg, p=0.001]; in the 24-hour DBP pressure load [AC: pre 45 (42) vs. powder 24 (35) %, p=0.016]; in the real mean variability of DBP [AC: pre 9 (3) vs. powder 8 (2); and WT pre 7 (3) vs. after 8 (3), CG: pre 7 (4) vs. after 7 (3), p=0.018. In the other variables, it was not possible to observe significant effects. In conclusion, the preliminary results of this clinical trial demonstrate that 12 weeks of AC training possibly reduces 24h DBP and waking DBP and MAP, DBP values in real mean variability and 24h pressure load in patients with PAD and symptoms of intermittent claudication. Instituição: Universidade Nove de Julho Tipo do documento: Dissertação