The diode laser energy delivered into small to median hemorrhoidal piles caused little pain and led to a partial to complete resolution within a short time compared to open hemorrhoidectomy. Some adjustments must be made to prevent burning lesions and residual plicoma. Although it is not a good method for big piles, this technique opens new possibilities for surgical treatment of hemorrhoidal disease.

ARTIGO DE REVISÃO | REVIEW ARTICLE RESUMOEste estudo propôs-se a realizar uma revisão sistemática da literatura a fim de verificar os efeitos da realidade virtual (RV) sobre a reabilitação de pacientes que sofreram acidente vascular encefálico (AVE). Foi realizada uma busca nas bases de dados eletrónicas Medline, Lilacs, Scielo e Pubmed, no período de 2004 a 2012. As palavras-chave utilizadas foram: realidade virtual, vídeo game, AVC, fisioterapia, reabilitação, virtual reality, stroke, rehabilitation e physiotherapy. Foram localizados 893 artigos e, ao final da seleção foram analisados nove estudos. Os resultados obtidos mostraram que o treino com RV pode contribuir para a reabilitação de pacientes que sofreram AVE. Os estudos selecionados utilizaram sete sistemas de RV para o treino das seguintes funções: marcha, equilíbrio, membro superior, cognição e perceção. Além disso, dependendo da função treinada, os autores utilizaram diferentes métodos de avaliação. Entretanto, mesmo os estudos que avaliaram funções similares utilizaram instrumentos de avaliação diferentes o que dificulta a comparação dos resultados. Conclui-se que a RV pode promover efeitos positivos na reabilitação de pacientes pós-AVE. Apesar dos resultados promissores, ainda são necessários novos estudos com maior número de sujeitos e melhor qualidade metodológica. Palavras-chave: acidente vascular cerebral, reabilitação, tecnologia ABSTRACT This study aimed to perform a systematic review to verify the effects of virtual reality (VR) on the rehabilitation of stroke patients. The search was conducted in the electronic databases Medline, Lilacs, Scielo and PubMed, from 2004 to 2012. The keywords selected for the search were: virtual reality, video game, stroke, physiotherapy, rehabilitation. It was found 893 articles, and at the end of selection, nine studies were included. The results showed that training with VR may contribute to the rehabilitation of stroke patients. The selected studies involved the use of seven different VR systems for training of functions: gait, balance, upper limb function, cognition and perception. Furthermore, depending on the function trained, the authors selected different assessment methods. However, even in the studies with similar functions assessed it was found different measurement techniques. The conclusion was that VR can promote positive effects on rehabilitation of post stroke patients. Despite promising results, further studies are needed with larger numbers of subjects and better methodological quality.

Este estudo teve como objetivo realizar uma revisão da literatura sobre os parâmetros de aplicação do ultrassom terapêutico no reparo tecidual do sistema musculoesquelético. Foi realizado um levantamento de dados sobre essa temática nas seguintes bases de dados: MEDLINE, LILACS e SciELO, em línguas portuguesa, inglesa e espanhola, sendo considerados apenas ensaios experimentais realizados em animais, publicados a partir de 2.000 e pesquisados até janeiro de 2.012. Foram encontrados 16 artigos sobre a utilização do ultrassom terapêutico no reparo tecidual, dos quais nove abordaram a lesão tendínea, quatro sobre reparo ósseo, dois verificaram o efeito na lesão muscular e um na lesão nervosa. Os achados desta revisão de literatura sobre as evidências científicas dos efeitos do ultrassom terapêutico no sistema musculoesquelético sugerem que não há padronização quanto à dosimetria adequada para o reparo tecidual deste, pois os artigos disponíveis são insuficientes para comprovar os seus reais efeitos e determinar os parâmetros indicados para este tipo de tratamento.

Background:Physiotherapy in the plastic surgery post-operative (PO) is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures.Aim:The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO.Design:This is a clinical trial prospective.Materials and Methods:Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels.Statistical Analysis:The test of equality for two proportions and the confidence interval test for mean to evaluate the distribution of variables. The significance level adopted for statistical tests was 5% (P < 0.05).Results:There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups.Conclusion:the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

The aim of this study was to evaluate the organization of collagen fibers in the healing process of rat Achilles tendon rupture using different times of ultrasound therapy (TUS). Forty Wistar rats were selected. Among these, 32 were submitted to total and divided into 5 groups: control group (CG, = 8), without tenotomy or any treatment; tenotomy group ( = 8), with tenotomy and without treatment; TUS groups-TUS3 ( = 8), TUS4 ( = 8), and TUS5 ( = 8)-submitted to tenotomy and treated with TUS for 3, 4, and 5 min per effective radiating area (ERA), respectively. The animals were sacrificed on the 12th postoperative day. The tendons were surgically removed for analysis of the collagen fiber organization using the birefringence technique (OR, optical retardation). The collagen fibers exhibited better aggregation and organization in the UST3, TUS4, and TUS5 groups compared with CG ( < 0.05). The TUS5 group had rates in intergroup comparison. The dose response of therapeutic TUS is influenced by many variables. The scientific evidence to support the dosimetry is insufficient. The application time is an important variable to be considered in TUS. In this study, the longer the application time, the better for organization and aggregation of collagen fibers in the rat tendon. TUS applied for 5 min per ERA presented higher dose response to the organization of collagen fibers in the healing process of rat Achilles tendon rupture.

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Skin flaps are still a matter of concern among surgeons, as failures can occur leading to flap necrosis. However, low-level laser irradiation has been reported as an effective tool to improve the viability of ischemic flaps, yet its mechanisms of action remain unclear. We investigated the effect of low-level laser irradiation on the viability of random skin flaps in rats and determined COX-2 expression in the flap pedicle. The study animals comprised 24 EPM-1 Wistar rats which were randomly allocated into three equal groups. A cranially based dorsal random skin flap measuring 10 × 4 cm was created in all the animals. In one group, laser irradiation was simulated (sham group), and in the other two groups the animals were irradiated at 12 points with 0.29 J at 20 mW (energy density 10.36 J/cm(2), irradiance 0.71 W/cm(2)), or with 7.3 J at 100 mW (energy density 260.7 J/cm(2), irradiance 3.57 W/cm(2)). These procedures were applied to the cranial half of the flap immediately after surgery and were repeated on days 2 and 5 after surgery. The percentage necrotic area was determined on day 7 after surgery by the paper template method. The immunohistochemical expression of COX-2 in the samples was given scores from 0 to 3. The necrotic area was smaller in group irradiated at 7.3 J compared to sham-treated group and to the group irradiated at 0.29 J (P < 0.05); there was no difference between the sham-treated group and group irradiated at 0.29 J. COX-2 expression was lower in the group irradiated at 7.3 J than in the sham-treated group and the group irradiated at 0.29 J (P < 0.001). Low-level laser therapy was effective in decreasing random skin flap necrosis in rats using a laser energy of 7.30 J per point. Laser irradiation also decreased the expression of COX-2 in the flap pedicle.

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