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Maciel KFF, Cordeiro AH, de Amorim RFB, Coelho LB, de Freitas Cordeiro M, Pinto TDA. Accelerating Healing and Relieving Pain: High-Intensity Laser Therapy for Paraneoplastic Cutaneous Vasculitis Associated with Multiple Myeloma. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e942322. [PMID: 38321712 PMCID: PMC10862082 DOI: 10.12659/ajcr.942322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/28/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Leukocytoclastic vasculitis (LCV) is an atypical form of cutaneous paraneoplastic manifestation. Its association with multiple myeloma (MM) is even rarer and is associated with poor prognosis and short survival, regardless of the therapy instituted. Different treatment approaches are necessary. We present a case in which LCV was the first manifestation of MM, and high-intensity laser therapy (HILT) was used as an option to accelerate healing and control pain. CASE REPORT A 76-year-old woman presented with pain and paresthesia in her lower limbs, associated with palpable purpura. The clinical diagnosis was small-vessel vasculitis. Laboratory tests showed an elevated gamma globulin monoclonal peak on protein electrophoresis. The immunophenotypic study of bone marrow aspirates led to the diagnosis of MM. Due to pain refractory to conventional analgesics, and the progressive evolution of the lesions, despite corticosteroid therapy, we performed photo-biomodulation with a neodymium-doped yttrium aluminum garnet laser (Nd: YAG), wavelength 1064 nanometers, using a 7-mm probe and energy density 6 J/cm². After the first session, the patient was referred for pain management, and after 5 weeks, we observed complete healing in ulcerated lesions and involution of bullous lesions. CONCLUSIONS This case report shows the positive effects of the Nd: YAG laser in modulating healing and reducing pain. HILT is an innovative, non-invasive, and effective treatment and should be considered a promising technique to accelerate healing and controlling pain.
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Affiliation(s)
| | | | | | - Ludmila Bertti Coelho
- Department of Vascular Surgery, Brasilia Institute of Angiology, Brasília, DF, Brazil
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Chaki C, De Taboada L, Tse KM. Three-dimensional irradiance and temperature distributions resulting from transdermal application of laser light to human knee-A numerical approach. JOURNAL OF BIOPHOTONICS 2023; 16:e202200283. [PMID: 37261434 DOI: 10.1002/jbio.202200283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
The use of light for therapeutic applications requires light-absorption by cellular chromophores at the target tissues and the subsequent photobiomodulation (PBM) of cellular biochemical processes. For transdermal deep tissue light therapy (tDTLT) to be clinically effective, a sufficiently large number of photons must reach and be absorbed at the targeted deep tissue sites. Thus, delivering safe and effective tDTLT requires understanding the physics of light propagation in tissue. This study simulates laser light propagation in an anatomically accurate human knee model to assess the light transmittance and light absorption-driven thermal changes for eight commonly used laser therapy wavelengths (600-1200 nm) at multiple skin-applied irradiances (W cm-2 ) with continuous wave (CW) exposures. It shows that of the simulated parameters, 2.38 W cm-2 (30 W, 20 mm beam radius) of 1064 nm light generated the least tissue heating -4°C at skin surface, after 30 s of CW irradiation, and the highest overall transmission-approximately 3%, to the innermost muscle tissue.
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Affiliation(s)
- Chironjeet Chaki
- Department of Mechanical and Product Design Engineering, Swinburne University of Technology, Melbourne, Australia
| | | | - Kwong Ming Tse
- Department of Mechanical and Product Design Engineering, Swinburne University of Technology, Melbourne, Australia
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Vieceli AS, Martins JC, Hendler KG, Santos APT, das Neves LMS, Barbosa RI, Kuriki HU, Marcolino AM. Effectiveness of electrophysical agents for treating pressure injuries: a systematic review. Lasers Med Sci 2022; 37:3363-3377. [PMID: 36201144 DOI: 10.1007/s10103-022-03648-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/18/2022] [Indexed: 02/04/2023]
Abstract
Tissue injuries that affect the skin and/or adjacent tissues and are usually over a bony prominence are called pressure injuries. The prevalence of these dysfunctions remains high, and despite technological advances, there is no consensus on the most appropriate treatment. The objective of this review was to evaluate the efficacy of photobiomodulation (PBM), ultrasound, and high-frequency electrophysical agents in the healing of pressure injuries in adults and the elderly. The search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and PEDro databases; in clinical trial records, a list of references of the selected articles, as well as through manual search (Google), of the last 5 years in humans in English and Portuguese. Nine thousand and sixty-seven studies were identified, 13 pre-selected, and 6 were included in this systematic review. PBM showed similar efficacy to other technologies indicated in other studies in healing pressure injuries. PBM with red wavelength (660 nm) in stages 2 and 3 pressure injuries effectively promoted healing compared to standard care. It was observed that the use of PBM accelerates tissue repair in pressure injuries; therapeutic ultrasound showed similar efficacy to other electrophysical agents but was effective in reducing the area of pressure injuries when comparing pre- and post-intervention. No clinical studies using the high-frequency electrophysical agent have been described in the last 5 years.
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Affiliation(s)
- Aline Santos Vieceli
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Juruciara Cristiano Martins
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Ketlyn Germann Hendler
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Ana Paula Tavares Santos
- Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Lais Mara Siqueira das Neves
- Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Rafael Inacio Barbosa
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Heloyse Uliam Kuriki
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil.,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil
| | - Alexandre Marcio Marcolino
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, SC, Brazil. .,Laboratory of Assessment and Rehabilitation of Locomotor System (LARAL), Federal University of Santa Catarina, Rua Pedro João Pereira, 150, CEP 88.905-120, Araranguá, SC, Brazil.
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Xue X, Bian Y, Yang M, Wei W, Meng L, Zhang Q, Tao J. Evaluation of injectable platelet-rich fibrin produced by a simple twice-centrifugation method combined with vacuum sealing drainage technology in the treatment of chronic refractory wounds. Front Bioeng Biotechnol 2022; 10:979834. [PMID: 36394016 PMCID: PMC9649671 DOI: 10.3389/fbioe.2022.979834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: To evaluate the effects of injectable platelet-rich fibrin (i-PRF) produced by a simple twice-centrifugation method combined with vacuum sealing drainage on wound inflammation and scar formation in chronic refractory wounds (CRW). Methods: A total of sixty-eight patients with CRW who were admitted to our hospital were enrolled in this study. They were then randomly divided into the study group (n = 34) with being treated using negative pressure sealing and drainage technology, and the control group (n = 34) with being treated using injectable platelet-rich fibrin in conjunction with negative pressure sealing and drainage technology. The following were the primary outcomes: scar conditions at 1 and 3 months after the wound was fully healed, wound healing time, hospitalization time, wound healing rate, incidence of adverse reactions, serum inflammatory indices, and pain levels were assessed 1 day before treatment and 14 days after treatment. The secondary outcomes were determined by comparing the proportion of positive bacterial cultures in the two groups on the day before therapy, as well as on the seventh and fourteenth days after treatment. Results: The wound healing time and hospital stay in the study group were significantly lower than that in the control group (all p < 0.001). The wound healing rate of the study group was significantly higher than that of the control group on the 14th day and 28th day after treatment (all p < 0.001). On the 14th day after treatment, the levels of WBC, CRP, and IL-6 in the study group were lower than those in the control group (all p < 0.001). The positive rate of bacterial culture in the study group was significantly lower than that in the control group on the 7th and 14th day after treatment (all p < 0.05). At 1 month and 3 months after treatment, the VSS score in the study group was lower than that in the control group (all p < 0.001). The total defect rate of the study group was also significantly lower than that of the control group (5.88% vs. 29.41%, p = 0.011). Conclusion: The i-PRF produced by simple twice-centrifugation method combined with VSD could reduce wound inflammation and improve scar formation in patients with CRW.
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Affiliation(s)
- Xin Xue
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuling Bian
- Department of Obstetrics and Gynecology, Hebei Water Conservancy Hospital, Shijiazhuang, China
| | - Meng Yang
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Wei
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lingmin Meng
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qingfu Zhang
- Department of Burn and Plastic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianguang Tao
- Department of Burn and Plastic Surgery, Handan Central Hospital, Handan, China
- *Correspondence: Jianguang Tao,
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