Photobiology and Photomedicine

Estimation of the influence of photobiomodulation on the endothelial function in patients with arterial hypertension under the conditions of hyperuricemia

2020-01-14T15:39:26+00:00

Introduction. In 2015, the global prevalence of hypertension in the world was estimated at 1.13 billion.
The European Association for the Treatment of Hypertension (ESH) updated its recommendations in 2018 and
officially added to the already existing risk factors of hypertension hyperuricemia. In patients with comorbidity
of hyperuricemia and hypertension, endothelial dysfunction is observed.
The aim of the study is to establish correlation between uric acid level and pulse wave velocity, Tei index,
endothelium-dependent vasodilation of the brachial artery and evaluate the effect of photobiomodulation on
endothelial dysfunction in patients with hypertension.
Materials and methods. The study included 102 patients with hypertension: 48 without hyperuricemia
(group 1) and 54 with comorbidity of hypertension and hyperuricemia (group 2). Groups 1A and 2A received antihypertensive
therapy. Groups 1B and 2B — antihypertensive therapy with a course of intravenous laser therapy
with a wavelength of 635 nm, course 10 procedures. Endothelium-dependent vasodilation of the brachial artery
was determined by a breakdown with reactive hyperemia. Tei index was calculated during echocardiography.
The pulse wave velocity was measured with a SonoScape S6 Pro.
Results. Antihypertensive therapy in group 1A reduced the rate of the pulse wave by 7.8 %. Antihypertensive
therapy and intravenous laser therapy in Group 1 reduced uric acid by 5.7 %, pulse rate by 12.2 %, Tei index by
9.5 %, increased endothelium dependent vasodilation of the brachial artery by 19.1 % (p < 0,05). Antihypertensive
therapy in Group 2A reduced uric acid by 4.7 %, pulse rate by 8.5 % and increased endothelium-dependent
brachial artery vasodilation by 31.7 %. Combined use of antihypertensive therapy and intravenous laser therapy
in group 2B reduced uric acid by 19.2 %, pulse wave speed by 21.9 %, Tei index by 29.0 %, increased endothelium-
dependent vasodilation of the brachial artery by 97.7 % < 0.05). A correlation was established between
uric acid level and endothelium dependent vasodilation of the brachial artery r = - 0.62 (p < 0.001) and between
uric acid level and pulse wave velocity r = + 0.68, uric acid level and systolic blood pressure (day ) r = + 0.48
(p < 0.001), uric acid level and Tei index r = + 0.47 (p < 0.05).
Conclusion. Given the established negative correlation between the mean strength between uric acid
level and endothelium-dependent vasodilation of the brachial artery, it is appropriate to use in clinical practice
a combination of antihypertensive therapy with intravenous laser therapy, which significantly reduces the level
of uterine fibrillation hypertension and in patients with comorbidity of hypertension and hyperuricemia.
Key words: hypertension, hyperuricemia, endothelial dysfunction, photobiomodulation, intravenous
laser therapy.

Modified photodynamic therapy of purulent wounds (experimental study)

2020-01-14T15:46:11+00:00

Introduction. The widespread use of antibiotics that have a mutagenic effect on the microflora causes a
change in the etiological structure of purulent infection, as well as the biological properties of the microbial cell
with the appearance of antibiotic-resistant strains of microorganisms. The consequence of this was a decrease
in the effectiveness of antibiotic therapy, traditionally prescribed local treatment of wounds and amid growing
allergization of the population. One of the promising methods of combating the antibiotic resistance of microorganisms
is antimicrobial photodynamic therapy.
Purpose. An experimental study is devoted to studying the results of the treatment of purulent wounds in the
first phase of the wound process using modified photodynamic therapy depending on the species of the pathogen.
Materials and methods. The study was conducted on 18 white Wistar male rats, divided into three
groups depending on the type of sanation of purulent wounds (6 animals in each series). In the control group,
wound treatment was performed by reorganization with chlorhexidine, in the second experimental group, photodynamic
therapy sessions were performed, in the third experimental group, the photosensitizer was modified
with chitosan. In dynamics, we studied the microbial contamination of wounds, the lethality of animals, and
also performed histological and morphometric studies.
Results. With regard to gram-negative rods, the use of «Photolon» as a photosensitizer led to a significant
reduction in bacterial contamination: in the crops, the number of germinated colonies was less than 10 bacteria/
ml, which suggests the selectivity of this type of photochemical effect with respect to gram-negative flora.
Conclusions. Modified PDT was effective against gram-negative bacilli (plating decreased from 3.70 ± 0.05 × 104
(log CFU/ml = 4.5682) to 2.90 ± 0.05 × 104 (log CFU/ml = 4.4623) and with respect to gram-positive pathogens:
the number of CFU/ml after the second session was < 1.0 ± 0.05 (log CFU/ml = 1). Histological and morphometric
studies showed the advantages of modified PDT compared to traditional treatment of purulent wounds.

Сombine therapy of patients with acne vulgaris comorbidity with functional disorder of hepatobiliary system and demodecosis

2020-01-14T15:49:14+00:00

Introduction. One of the common chronic dermatoses that have a direct impact on the quality of life of
patients is acne. The occurrence of psycho-emotional disorders due to the location of elements in the open areas
of the body. Given the high prevalence of acne in puberty (up to 85 % of adolescents have episodes of acne of varying severity), there is a need to find new algorithms for acne treatment to prevent the progression of social
maladaptation and depressive states.
Materials and methods. The study included 140 patients who were divided into 3 groups depending
on the presence of comorbid pathology and treatment methods: group 1 — patients with acne who were
underwent standard treatment for 60 days, group 2 — patients with acne in comorbidity with demodecosis,
group 3 — patients with acne in comorbidity with demodecosis and functional disorders of the digestive system,
who were additionally treated with a laser therapy. Treatment efficacy was evaluated using the GAGS scale and
the DLQI questionnaire on days 14, 28 and 60 of therapy.
Results. Evaluation of the results on day 60 shows a decrease in the manifestations of inflammation by 50 %
in groups 2 and 3, and by 29 % in the standard therapy group. Improving of the quality of life in groups 2 and 3
was by 70 %, while in the group 1 — by 35 %. The following correlations were established: r = + 0.9 — between the
severity of VC manifestations and the presence of comorbid pathology, r = + 0.71 — between the severity of VC
and the assessment of quality of life, r = + 0.69 — between the presence of acne comorbidity with demodecosis
and FDGBS and the effect on quality of life (p < 0.005).
Conclusions. Optimization of the treatment algorithm for acne patients in comorbidity with demodecosis
and functional disorders of the hepatobiliary system is achieved by the use of combined treatment using laser
therapy, which significantly improves the quality of life of patients.

Photodynamic therapy of gunshot wounds soft tissue

2020-01-14T15:51:12+00:00

Introduction. An important component of the treatment of gunshot wounds is antibiotic therapy.
Unfortunately, due to the antibiotic resistance of many strains of microorganisms, there remains a risk of purulent-
infectious complications even with prolonged antibiotic therapy. In recent years, methods of physical
action, in particular, photodynamic therapy (PDT), have been used to accelerate bacterial decontamination of
wounds. Gunshot wounds have their own characteristics that create certain difficulties for the application of
the method of photodynamic therapy.
Purpose. Аnalyzes the results of the application of the developed PDT method in the complex treatment
of gunshot wounds of soft tissues.
Materials and methods. A comparison was made of the main indicators of the wound healing process
between the wounded of the main group who used PDT (n = 52) and the comparison group (n = 32) who used
treatment with complex water-soluble ointments. To increase the effectiveness of the method, the «Photolon»
photosensitizer was administered in two ways: by injection infiltration of tissues around the wound and by application
directly to the wound surface. The wavelength of laser radiation is 660 nm. The dose of laser energy
was 20 J/cm2.
Results. The results of the study showed an improvement in the course of the wound process in all respects
when using PDT: the period of regression of local edema in the main group on (3.7 ± 0.4) days in the comparison
group (6.2 ± 0.5), the period of wound cleansing (4.7 ± 0.6) days (7.3 ± 0.8) days, respectively; the timing of the
start of granulation (4.6 ± 0.5) days and (7.8 ± 0.6). At the beginning of treatment, 45 pathogenic strains were
isolated in 38 (73.1 %) wounded main groups and 26 strains in 22 (68.7 %) wounded comparison groups. A day
after the use of PDT, pathogenic wound microflora was isolated in 5 (9.6 %) wounded main groups — 5 strains
and 23 strains in 19 (59.4 %) wounded comparison groups.
Conclusions. The effects of PDT were observed: rapid inactivation of pathogenic wound microflora,
reduction of edema, pain syndrome and stimulation of granulation growth, which contributes to early closure
of wounds.

Low-level laser therapy in rehabilitation of patients with ischemic heart disease: review of evidence-based studies

2020-01-14T15:54:06+00:00

Introduction. Cardiac rehabilitation is one of the main achievements of cardiology and physical rehabilitation
medicine in the second half of the 20th century. Based on the methodology of evidence-based medicine,
cardiac rehabilitation in a short time evolved from a “fictional” “alternative” unproven treatment direction to
completely uncontested and proven multidisciplinary programs. This article presents contemporary findings on
cardiorehabilitation and analysis of evidence-based experimental and clinical studies of low-level laser therapy
efficiency in patients with ischemic heart disease.
Aim. To search for evidence-based investigations on application of low-level laser therapy for rehabilitation
of patients with ischemic heart disease and to analyze their major propositions and recommendations.Materials and methods. PEDro, EMBASE, PubMed and Cochrane library electronic databases were
searched for randomized clinical trials, systematic reviews, meta-analyses and clinical protocols using the key
words within 2000–2019 years.
Results and discussion: experimental and clinical investigations were carefully considered and the
following findings were analyzed: action mechanisms of low-level laser therapy, its positive influence on
myocardial remodeling, infarction area reduction, restenosis prevention and presented cardioprotective effect.
More attention was focused at clinical evidence-based studies on application of photobiomodulation in order to
increase the efficacy of surgical and percutaneous myocardial revascularization, and in non-invasive cardiology
and physical rehabilitation medicine.
Conclusion: regular analysis of performed studies and realization of new evidence-based investigation
should be conducted to evaluate the efficiency of low-level laser therapy in rehabilitation of patients with
ischemic heart disease

Microcirculation state analysis in patients with pathology of intrinosular structures with respiratory-reference disorders

2020-01-14T15:55:57+00:00

Introduction. Capillary changes link are closely correlated with shifts in central hemodynamics, which
allows the use of microcirculation parameters as diagnostic and prognostic criteria for assessing the body as
a whole. The work is aimed at increasing the efficiency of detecting microcirculatory disorders by computer
capillaroscopy in patients with pathology of intranasal structures and accompanied by difficulty in nasal
breathing and smell.
Purpose: nature and severity analysis of intravital morphological changes in the microvessels of the nail
bed in patients with pathology of the intranasal structures, accompanied by impaired nasal breathing and smell.Materials and methods: We examined 145 patients aged 18–38 years who were diagnosed with changes
in intranasal structures with varying degrees of nasal obstruction and impaired sense of smell. Patients were
divided into 3 groups. The first group — patients with a disease duration of 3–5 years; the second group — patients
with a disease duration of up to 0.5 years; the third group — patients with a disease duration of up to 1 month.
Results: Patients with intranasal structures pathology in the I and III clinical groups with a duration of nasal
obstruction up to 5 years and 1 month. Changes in systemic microcirculation were significantly more frequently
observed than in patients with a disease duration of up to 0.5 years. The observed tendency to disturbance of
microcirculation in groups III and I is caused, first of all, by a change in the state of microvessels for sharp
hypoxia (these changes are consistent with rhinomanometry) and a “breakdown” of adaptation mechanisms in
the group of prolonged nasal obstruction for up to 5 years, at that time as in group II, there is an increase in the
reserve of adaptation from the cardiovascular system to the conditions of nasal obstruction.
Сonclusions: The study of microcirculation using capillaroscopy made it possible to study the smallest
vessels, capillaries, which are the first to respond to impaired nasal breathing by changing the functional state
and morphological reconstruction of the microvasculature of the bloodstream.

Photoinactivation of staphylococcus aureus in vitro by red light (660 nm) in the presence of methylene blue

2020-01-14T15:57:23+00:00

Introduction. Оpen wounds and ulcers treatment involves the use of bandage material, antibiotics and
antiseptic to prevent the development of a pathogenic microflora and to provide the necessary conditions for
tissue regeneration. An emergence of multi-resistant strains of microorganisms reduces the effectiveness of such
technology and requires the new treatment approaches. One of the promising areas is a photodynamic therapy
with the use of external photosensitizers.
The aim of the investigation is to determine the effectiveness of the synergistic action of red light (660 nm)
and different concentrations of methylene blue on the inhibition of Staphylococcus aureus growth.
Materials and methods. We used the hydrogels based on the copolymers dextran-polyacrylamide with
the different concentration of crosslinking agent 0.2 %, 0.4 %, 0.6 % (w/w) for investigation a rate of diffusion
methylene blue into and out from hydrogel. Microbiological research was performed on wild strains of S. aureus
isolated on a Yolk-salt agar. The evaluation of a bactericidal action of methylene blue was carried out on a
Müller-Hinton No. 2 agar similarly to the disc-diffusion method for assessing the resistance of microorganisms
to antibiotics. For irradiation by different wavelengths was used «LIKA-Led» (Photonics Plus) LEDs 390 nm,
460 nm and 660 nm. The radiation power for each wavelength was 100 mW, duration — 20 min, 30 min, 40 min.
According to the duration, the irradiation doses were 21 J/cm2, 31.5 J/cm2, 42.1 J/cm2. Mathematical and
statistical data processing was performed in the OriginLab 8.0 software package.
Results. Increasing the amount of crosslinking agent in the hydrogel based on the copolymer dextran-polyacrylamide
provides a decrease in the diffusion rate of methylene blue from the hydrogel. 390 nm ultraviolet
radiation reduces the number of S. aureus colonies for 80% at 20 min exposure. Further increase in the exposure
did not contribute to significant changes in this indicator. Blue light (460 nm) reduces the presence of this
strain of microorganisms for 66% at 20 min exposure and reaches the effect of UV at 30 min exposure. Red
light (660 nm) has no bactericidal effect. Minimal activity was found for methylene blue at concentrations of
0.001% and 0.0001% which was around 6 mm. The synergistic effect of 0.001% methylene blue and red light
increases the activity for 40% up to 10 mm.
Conclusions. For the photoinactivation of Staphylococcus aureus, it is advisable to use a low energy red
light with a 660 nm wavelength in combination with a saturated methylene blue (0.001%) hydrogels. Perhaps
the synergistic action of red light and dye provides a generation of active radicals that contribute to the growth
retardation of microorganisms.