968 resultados para Experimental treatment
Resumo:
Animal models of bone marrow transplantation (BMT) allow evaluation of new experimental treatment strategies. One potential strategy involves the treatment of donor marrow with ultra-violet B light to allow transplantation across histocompatibility boundaries without an increase in graft rejection or graft-versus-host disease. A major requirement for a new experimental protocol, particularly if it involves manipulation of the donor marrow, is that the manipulated marrow gives rise to long-term multilineage engraftment. DNA based methodologies are now routinely used by many centres to evaluate engraftment and degree of chimaerism post-BMT in humans. We report the adaptation of this methodology to the serial study of engraftment in rodents. Conditions have been defined which allow analysis of serial tail vein samples using PCR of short tandem repeat sequences (STR-PCR). These markers have been used to evaluate the contribution of ultraviolet B treated marrow to engraftment following BMT in rodents without compromising the health of the animals under study. Chimaerism data from sequential tail vein samples and bone marrow from selected sacrificed animals showed excellent correlation, thus confirming the validity of this approach in analysing haemopoietic tissue. Thus the use of this assay may facilitate experimental studies in animal BMT.
Resumo:
This study was undertaken in order to determine the
effects of playing computer based text adventure games on
the reading comprehension gains of students. Forty-five
grade five students from one elementary school were
randomly assigned to experimental and control groups, and
were tested with regard to ability, achievement and reading
skills. An experimental treatment, consisting of playing
computer based interactive fiction games of the student's
choice for fifteen minutes each day over an eight-week
period, was administered. A comparison treatment engaged
the control group in sustained silent reading of materials of
the student's choice for an equal period of time. Following
the experimental period all students were post-tested with an
alternate form of the pre-test in reading skills, and gain
scores were analysed. It was found that there were no
significant differences in the gain scores of the experimental
and control groups for overall reading comprehenSion, but the
experimental group showed greater gains than the control
group in the structural analysis reading sub-skill. Extreme
variance in the data made generalization very difficult, but
the findings indicated a potential for computer based
interactive fiction as a useful tool for developing reading
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La prééclampsie est responsable du quart des mortalités maternelles et est la deuxième cause de décès maternels associés à la grossesse au Canada et dans le monde. L’identification d’une stratégie efficace pour la prévention de la prééclampsie est une priorité et un défi primordial dans les milieux de recherche en obstétrique. Le rôle des éléments nutritifs dans le développement de la prééclampsie a récemment reçu davantage d’attention. Plusieurs études cliniques et épidémiologiques ont été menées pour déterminer les facteurs de risque alimentaires potentiels et examiner les effets d’une supplémentation nutritive dans le développement de troubles hypertensifs de la grossesse. Pour déterminer les effets de suppléments antioxydants pris pendant la grossesse sur le risque d’hypertension gestationnelle (HG) et de prééclampsie, un essai multicentrique contrôlé à double insu a été mené au Canada et au Mexique (An International Trial of Antioxidants in the Prevention of Preeclampsia – INTAPP). Les femmes, stratifiées par risque, étaient assignées au traitement expérimental quotidien (1 gramme de vitamine C et 400 UI de vitamine E) ou au placebo. En raison des effets secondaires potentiels, le recrutement pour l’essai a été arrêté avant que l’échantillon complet ait été constitué. Au total, 2640 femmes éligibles ont accepté d’être recrutées, dont 2363 (89.5%) furent incluses dans les analyses finales. Nous n’avons retrouvé aucune évidence qu’une supplémentation prénatale de vitamines C et E réduisait le risque d’HG et de ses effets secondaires (RR 0,99; IC 95% 0,78-1,26), HG (RR 1,04; IC 95% 0,89-1,22) et prééclampsie (RR 1,04; IC 95% 0,75-1,44). Toutefois, une analyse secondaire a révélé que les vitamines C et E augmentaient le risque de « perte fœtale ou de décès périnatal » (une mesure non spécifiée au préalable) ainsi qu’une rupture prématurée des membranes avant terme. Nous avons mené une étude de cohorte prospective chez les femmes enceintes recrutées dans l’INTAPP afin d’évaluer les relations entre le régime alimentaire maternel en début et fin de grossesse et le risque de prééclampsie et d’HG. Un questionnaire de fréquence alimentaire validé était administré deux fois pendant la grossesse (12-18 semaines, 32-34 semaines). Les analyses furent faites séparément pour les 1537 Canadiennes et les 799 Mexicaines en raison de l’hétérogénéité des régimes alimentaires des deux pays. Parmi les canadiennes, après ajustement pour l’indice de masse corporelle (IMC) précédant la grossesse, le groupe de traitement, le niveau de risque (élevé versus faible) et les autres facteurs de base, nous avons constaté une association significative entre un faible apport alimentaire (quartile inférieur) de potassium (OR 1,79; IC 95% 1,03-3,11) et de zinc (OR 1,90; IC 95% 1,07-3,39) et un risque augmenté de prééclampsie. Toujours chez les Canadiennes, le quartile inférieur de consommation d’acides gras polyinsaturés était associé à un risque augmenté d’HG (OR 1,49; IC 95% 1,09-2,02). Aucun des nutriments analysés n’affectait les risques d’HG ou de prééclampsie chez les Mexicaines. Nous avons entrepris une étude cas-témoins à l’intérieur de la cohorte de l’INTAPP pour établir le lien entre la concentration sérique de vitamines antioxydantes et le risque de prééclampsie. Un total de 115 cas de prééclampsie et 229 témoins ont été inclus. Les concentrations de vitamine E ont été mesurées de façon longitudinale à 12-18 semaines (avant la prise de suppléments), à 24-26 semaines et à 32-34 semaines de grossesse en utilisant la chromatographie liquide de haute performance. Lorsqu’examinée en tant que variable continue et après ajustement multivarié, une concentration de base élevée de gamma-tocophérol était associée à un risque augmenté de prééclampsie (quartile supérieur vs quartile inférieur à 24-26 semaines : OR 2,99, IC 95% 1,13-7,89; à 32-34 semaines : OR 4,37, IC 95% 1,35-14,15). Nous n’avons pas trouvé de lien entre les concentrations de alpha-tocophérol et le risque de prééclampsie. En résumé, nous n’avons pas trouvé d’effets de la supplémentation en vitamines C et E sur le risque de prééclampsie dans l’INTAPP. Nous avons toutefois trouvé, dans la cohorte canadienne, qu’une faible prise de potassium et de zinc, tel qu’estimée par les questionnaires de fréquence alimentaire, était associée à un risque augmenté de prééclampsie. Aussi, une plus grande concentration sérique de gamma-tocophérol pendant la grossesse était associée à un risque augmenté de prééclampsie.
Resumo:
En el presente estudio se analizan los efectos de los fotoperiodos ambientales de otoño e invierno y los fotoperiodos experimentales de 24, 12 y 0 horas de luz artificial sobre la calidad del semen de machos reproductores porcinos de raza Landrace. El estudio se realizó sobre 30 machos postpuberales de 8 meses de edad y testados con el fin de comprobar la homogeneidad. Los machos fueron distribuidos aleatóriamente en los 3 grupos de luz artificial durante 3 meses. El tratamiento de 12 horas de luz artificial fue considerado como grupo control. Previamente al inicio de cada tratamiento, se sometió a cada grupo de machos al fotoperiodo ambiental correspondiente a la época del año; así, se caracterizó también la calidad seminal en otoño e invierno, manteniendo la temperatura constante. La nave experimental que acogió a los machos tiene una superficie de 100 m2 y una altura de 3,5 m. Un pasillo central divide la nave en dos hileras de 5 y 6 celdas respectivamente. En una de las celdas pequeñas se instaló el maniquí y fue utilizada para las extracciones de semen. La iluminación artificial se consiguió con la instalación de 6 lámparas fluorescentes en el techo del pasillo central que proporcionaron una luz homogénea superior a 200 lux. Así mismo, la nave se mantuvo en todo momento a 21±1ºC y la humedad relativa osciló entre el 60-75%. A todos los verracos se les proporcionó una dieta nutritiva y equilibrada y se les sometió a un regimen de extracciones de semen de 2 veces por semana, habiendo sido previamente entrenados en la monta del maniquí. Les muestras de semen fueron recogidas según la técnica de la mano enguantada (Martín, 1982; Daza, 1992) y se analizaron los siguientes parámetros: el volumen y el pH seminales, la concentración, la vitalidad y la motilidad espermáticas, la resistencia acrosómica de los espermatozoides, la morfología espermàtica a partir de la frecuencia de los espermatozoides maduros, inmaduros y aberrantes, la producción testicular y el número de dosis seminales. Se analizó, además, bioquímicamente el plasma seminal al principio y al final de cada tratamiento experimental de luz artificial a partir de la concentración de proteína total, de la identificación de residuos fosforilados de proteína y del contenido de azúcares. También se determinaron los índices de fertilidad y prolificidad. El volumen y el pH de los eyaculados se utilizaron como marcadores del estado funcional de las glándulas sexuales accesorias; la concentración espermàtica como un indicador de la actividad testicular (Pinart y col., 1999). La vitalidad y la motilidad espermáticas fueron estimadores del grado de diferenciación del espermatozoide tanto a nivel testicular como epididimario; la resistencia acrosómica fue utilizada para valorar el nivel de diferenciación de la membrana acrosómica durante la espermiogénesis y/o maduración epididimària (Briz i col., 1996; Pinart i col., 1999). Referente a la morfología espermática, los espermatozoides inmaduros fueron marcadores de anomalías en la maduración de éstos a lo largo del conducto epididimario y los espermatozoides aberrantes se utilizaron como marcadores de una diferenciación defectuosa a nivel de testículo (anomalías primarias) y a nivel de conducto epididimario (anomalías secundarias) (Briz i col., 1996). La concentración de proteína total se utilizó para valorar la integridad funcional de las membranas del espermatozoide y la actividad de las glándulas sexuales accesorias. La identificación de proteínas con residuos de tirosina fosforilados fue un estimador de la viabilidad celular y la actividad de las glándulas sexuales, y el contenido de azúcares como un indicador de la producción de las vesículas seminales. La determinación del volumen y el pH de los eyaculados se realizó en las instalaciones de la granja a partir de semen fresco el mismo día de la extracción. El resto de parámetros se analizaron en el laboratorio durante las 48 horas posteriores a la extracción a partir de semen diluido en BTS (diluyente de Bestville) (Daza, 1992) y transportado y conservado a 15ºC. Las muestras fueron previamente filtradas con el fin de eliminar la tapioca. El estudio estadístico de los resultados obtenidos se realizó a partir del análisis de la varianza (ANOVA) con un nivel de significación de =0,05. En cuanto al estudio comparativo de los fotoperiodos ambientales estacionales se ha observado un incremento significativo del pH del eyaculado en los machos expuestos a otoño (P0,0001), mientras que el volumen seminal se mantiene en valores similares en ambos tratamientos (P=0,1650). La concentración espermàtica, la producción espermàtica y el número de dosis seminales que se pueden preparar a partir de un eyaculado se duplica en los verracos sometidos al fotoperiodo de primavera (P0,0001). La vitalidad y la motilidad espermáticas no experimentan cambios significativos entre tratamientos (P=0,3440 y P=0,9220, respectivamente). La resistencia osmótica de los acrosomas desciende únicamente en los machos expuestos a condiciones estacionales de otoño (P0,0001). En referencia a la morfología espermàtica aunque no se observan diferencias entre primavera y otoño (P0,05), sí se detecta un incremento de los porcentajes de espermatozoides inmaduros y aberrantes en ambos fotoperiodos estacionales, y en especial en los machos expuestos a condiciones fotoperiódicas de otoño. Según los resultados obtenidos en este estudio la calidad seminal de los verracos es inferior en el fotoperiodo de otoño debido a un descenso de la concentración y la producción espermáticas, un aumento del pH seminal, una disminución de la resistencia de la membrana acrosómica y a un incremento en la frecuencia de espermatozoides inmaduros y aberrantes. Parece ser, pues, que en el otoño tiene lugar la disminución de la producción testicular, cambios en la actividad de las glándulas sexuales accesorias y disfunciones en el proceso de diferenciación testicular y epididimària de los espermatozoides y especialmente del acrosoma. En relación a los resultados obtenidos en el estudio de los diferentes fotoperiodos artificiales se observa que la iluminación continua provoca un aumento significativo del volumen del eyaculado en el primer y segundo mes de tratamiento (P0,0001), disminuyendo en el tercer mes. La oscuridad absoluta no modifica este parámetro (P0,05). En cuanto al pH seminal la iluminación continua provoca un incremento progresivo del valor del pH a lo largo del periodo experimental (P0,0001), mientras que la oscuridad absoluta tiene un efecto más irregular. La exposición de los machos a iluminación continua y a oscuridad absoluta se manifiesta en un descenso de la concentración y la producción espermáticas que se mantiene hasta el segundo mes de tratamiento (P0,0001), observándose un incremento en el tercer mes de exposición de los machos a oscuridad absoluta (P=0,1010). De todas maneras, este descenso es mas severo en los machos sometidos a iluminación continua ya que no presentan recuperación. La vitalidad y la motilidad espermáticas no se ven alteradas por la iluminación continua y la oscuridad absoluta, ni tampoco el contenido de los azúcares mayoritarios del plasma seminal (P0,005). La glucosa aparece como un azúcar minoritario y sí que presenta concentraciones inferiores en los tratamientos experimentales de luz continua y de oscuridad absoluta (P0,0001 y P=0,0002, respectivamente). La resistencia osmótica de los acrosomas desciende en ambos tratamientos artificiales extremos de luz continua y oscuridad total (P0,0001), aunque en los machos expuestos a iluminación continua se produce una recuperación a partir del segundo mes de tratamiento (P=0,4930). Dado que tampoco se han observado diferencias significativas en las concentraciones de proteína total (P0,05), es probable que las anomalías de la membrana acrosómica se originen durante el proceso de espermiogénesis y/o maduración epididimària. La exposición de los verracos a oscuridad absoluta no altera la morfología espermàtica de los eyaculados, aunque se observa un aumento de la frecuencia de espermatozoides con anomalías en la forma de la cola en el primer mes (P0,0001), y un aumento de la frecuencia de espermatozoides inmaduros con gota distal y de espermatozoides con anomalías en el número de colas en el tercer mes de experimentación (P=0,0030 y P0,0001). La luz continua, sin embargo, provoca un incremento de la frecuencia de espermatozoides inmaduros con gota distal (P0,0001) y de espermatozoides con anomalías en la forma de la cola (P=0,0040) ya en el primer mes. El fotoperiodo provoca un descenso de la fertilidad de los machos expuestos a oscuridad absoluta en el tercer mes de tratamiento (P0,0001) y un incremento de ésta en los machos sometidos a iluminación continua (P=0,0005). La prolificidad no se ve modificada por ambas condiciones extremas de luz artificial (P0,05). Así pues, los resultados obtenidos demuestran que el fotoperiodo afecta la actividad testicular, provoca alteraciones en la actividad de las glándulas sexuales accesorias, altera el proceso de expulsión de la gota citoplasmática y provoca anomalías en el proceso de diferenciación de la cola tanto a nivel testicular como epididimario, siendo los verracos expuestos a luz continua más sensibles a estos parámetros que los verracos sometidos a oscuridad absoluta. El fotoperiodo, sin embargo, no altera de forma esencial la integridad de las membranas del espermatozoide ni la capacidad fecundante de éste.
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A number of authors have proposed clinical trial designs involving the comparison of several experimental treatments with a control treatment in two or more stages. At the end of the first stage, the most promising experimental treatment is selected, and all other experimental treatments are dropped from the trial. Provided it is good enough, the selected experimental treatment is then compared with the control treatment in one or more subsequent stages. The analysis of data from such a trial is problematic because of the treatment selection and the possibility of stopping at interim analyses. These aspects lead to bias in the maximum-likelihood estimate of the advantage of the selected experimental treatment over the control and to inaccurate coverage for the associated confidence interval. In this paper, we evaluate the bias of the maximum-likelihood estimate and propose a bias-adjusted estimate. We also propose an approach to the construction of a confidence region for the vector of advantages of the experimental treatments over the control based on an ordering of the sample space. These regions are shown to have accurate coverage, although they are also shown to be necessarily unbounded. Confidence intervals for the advantage of the selected treatment are obtained from the confidence regions and are shown to have more accurate coverage than the standard confidence interval based upon the maximum-likelihood estimate and its asymptotic standard error.
Resumo:
Sequential methods provide a formal framework by which clinical trial data can be monitored as they accumulate. The results from interim analyses can be used either to modify the design of the remainder of the trial or to stop the trial as soon as sufficient evidence of either the presence or absence of a treatment effect is available. The circumstances under which the trial will be stopped with a claim of superiority for the experimental treatment, must, however, be determined in advance so as to control the overall type I error rate. One approach to calculating the stopping rule is the group-sequential method. A relatively recent alternative to group-sequential approaches is the adaptive design method. This latter approach provides considerable flexibility in changes to the design of a clinical trial at an interim point. However, a criticism is that the method by which evidence from different parts of the trial is combined means that a final comparison of treatments is not based on a sufficient statistic for the treatment difference, suggesting that the method may lack power. The aim of this paper is to compare two adaptive design approaches with the group-sequential approach. We first compare the form of the stopping boundaries obtained using the different methods. We then focus on a comparison of the power of the different trials when they are designed so as to be as similar as possible. We conclude that all methods acceptably control type I error rate and power when the sample size is modified based on a variance estimate, provided no interim analysis is so small that the asymptotic properties of the test statistic no longer hold. In the latter case, the group-sequential approach is to be preferred. Provided that asymptotic assumptions hold, the adaptive design approaches control the type I error rate even if the sample size is adjusted on the basis of an estimate of the treatment effect, showing that the adaptive designs allow more modifications than the group-sequential method.
Resumo:
This paper presents a simple Bayesian approach to sample size determination in clinical trials. It is required that the trial should be large enough to ensure that the data collected will provide convincing evidence either that an experimental treatment is better than a control or that it fails to improve upon control by some clinically relevant difference. The method resembles standard frequentist formulations of the problem, and indeed in certain circumstances involving 'non-informative' prior information it leads to identical answers. In particular, unlike many Bayesian approaches to sample size determination, use is made of an alternative hypothesis that an experimental treatment is better than a control treatment by some specified magnitude. The approach is introduced in the context of testing whether a single stream of binary observations are consistent with a given success rate p(0). Next the case of comparing two independent streams of normally distributed responses is considered, first under the assumption that their common variance is known and then for unknown variance. Finally, the more general situation in which a large sample is to be collected and analysed according to the asymptotic properties of the score statistic is explored. Copyright (C) 2007 John Wiley & Sons, Ltd.
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There is growing interest, especially for trials in stroke, in combining multiple endpoints in a single clinical evaluation of an experimental treatment. The endpoints might be repeated evaluations of the same characteristic or alternative measures of progress on different scales. Often they will be binary or ordinal, and those are the cases studied here. In this paper we take a direct approach to combining the univariate score statistics for comparing treatments with respect to each endpoint. The correlations between the score statistics are derived and used to allow a valid combined score test to be applied. A sample size formula is deduced and application in sequential designs is discussed. The method is compared with an alternative approach based on generalized estimating equations in an illustrative analysis and replicated simulations, and the advantages and disadvantages of the two approaches are discussed.
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Seamless phase II/III clinical trials combine traditional phases II and III into a single trial that is conducted in two stages, with stage 1 used to answer phase II objectives such as treatment selection and stage 2 used for the confirmatory analysis, which is a phase III objective. Although seamless phase II/III clinical trials are efficient because the confirmatory analysis includes phase II data from stage 1, inference can pose statistical challenges. In this paper, we consider point estimation following seamless phase II/III clinical trials in which stage 1 is used to select the most effective experimental treatment and to decide if, compared with a control, the trial should stop at stage 1 for futility. If the trial is not stopped, then the phase III confirmatory part of the trial involves evaluation of the selected most effective experimental treatment and the control. We have developed two new estimators for the treatment difference between these two treatments with the aim of reducing bias conditional on the treatment selection made and on the fact that the trial continues to stage 2. We have demonstrated the properties of these estimators using simulations
Resumo:
Recently, in order to accelerate drug development, trials that use adaptive seamless designs such as phase II/III clinical trials have been proposed. Phase II/III clinical trials combine traditional phases II and III into a single trial that is conducted in two stages. Using stage 1 data, an interim analysis is performed to answer phase II objectives and after collection of stage 2 data, a final confirmatory analysis is performed to answer phase III objectives. In this paper we consider phase II/III clinical trials in which, at stage 1, several experimental treatments are compared to a control and the apparently most effective experimental treatment is selected to continue to stage 2. Although these trials are attractive because the confirmatory analysis includes phase II data from stage 1, the inference methods used for trials that compare a single experimental treatment to a control and do not have an interim analysis are no longer appropriate. Several methods for analysing phase II/III clinical trials have been developed. These methods are recent and so there is little literature on extensive comparisons of their characteristics. In this paper we review and compare the various methods available for constructing confidence intervals after phase II/III clinical trials.
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Studies on the effects of changes in biodiversity and ecosystem functioning have been a central theme in ecology over the past two decades. Several studies have showed that the diversity of plant debris differently affects the decomposition process in aquatic and terrestrial environments, but we know very about the effects of detritus diversity on decomposition under fluctuating environmental conditions. We tested whether and how the environmental contexts, as well as the dynamic of their alternation, influence the effects of detritus diversity on the decomposition process. We performed a field experiment where we manipulate the litter diversity of 8 species of terrestrial plants decomposing (litterbags) in single and in mixture containing the eight species together in three different environmental contexts: the terrestrial environment (T), aquatic (A) and interface (I) - experimental treatment that simulates variation in flooding regime. We measured the rate of decomposition through the loss of mass of the community and each individual detritus in monocultures and mixtures. Species richness and environmental variability had no effects on the magnitude and stability of the decomposition process. However, there were significant diversity effects on the decomposition of an individual alien species, F. benjamina. Environmental context had significant effects on the magnitude and variability of decomposition. Detritus decomposition was faster and more variable on aquatic, interface and terrestrial conditions, respectively. Our results demonstrate that the diversity of plant detritus has minor effects to the decomposition across disparate environmental conditions and suggest that it is necessary to consider the potential of other abiotic factors in affect the magnitude and variability of the decomposition processes
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Uma das opções para o manejo de Salvina molesta é o controle químico; contudo, a presença de grande quantidade de pêlos na epiderme foliar reduz a molhabilidade das folhas, o que pode afetar a eficiência dos herbicidas. O objetivo deste trabalho foi o de avaliar a deposição do corante azul FDC-1, no qual se simulou a aplicação de herbicidas em plantas dessa espécie, com e sem a mistura de um surfatante. Os tratamentos foram as concentrações de 0 e 5% do surfatante Aterbane (espalhante adesionante), utilizado na elaboração da calda de pulverização. O delineamento experimental foi o inteiramente casualizado, com 150 repetições. A aplicação foi realizada com um pulverizador estacionário à pressão de 2,0 bar, com consumo de calda de 180 L ha-1. Foram utilizados bicos de jato plano, tipo XR 110.02. Foram ajustadas curvas de regressão entre os depósitos individuais em cada planta (mL calda/planta) e as freqüências acumuladas. Utilizou-se o modelo de Gompertz, e os valores de R² foram de 0,99 e 0,97 com e sem o espalhante, respectivamente. em termos médios, a adição de Aterbane reduziu em 1,13% os depósitos do FDC-1. No entanto, o espalhante melhorou em 76, 41 e 29% a deposição em 1, 5 e 10% da população com menores depósitos do corante.
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Opioids may exert a protective effect against ventricular arrhythmias via a vagally mediated mechanism. This study evaluated the effects of the opioid remifentanil on arrhythmogenicity of epinephrine during halothane anesthesia. Eight dogs were assigned to 2 treatments in a randomized crossover design, with 1-week intervals between treatments. Anesthesia was maintained with 1.3% end-tidal halothane in oxygen and mechanical ventilation to maintain eucapnia. A constant rate infusion of remifentanil (0.72 mu g/kg/min) was administered throughout the study in the experimental treatment, while control animals received physiologic saline as placebo. The arrhythmogenic dose of epinephrine (ADE), defined as 4 premature ventricular complexes (PVCs) within 15 s, was determined by administering progressively increasing infusion rates of epinephrine (2.5, 5.0, and 10 mu g/kg/min), allowing 20 min intervals between each infusion rate. In both treatments, epinephrine infusions induced bradyarrhythmias and atrioventricular conduction disturbances, which were followed by escape beats and PVCs. In the remifentanil treatment, mean s ADE values (11.3 +/- 4.9 mu g/kg) did not differ from values observed in control animals (9.9 +/- 6.1 mu g/kg). on the basis of the ADE model for assessing the arrhythmogenity of drugs during halothane anesthesia, the present study did not demonstrate a protective effect of remifentanil (0.72 mu g/kg/min) against ventricular arrhythmias in dogs.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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The use of low-level laser (LLL) may be an useful tool to promote reduction of muscular pain caused by TMD. Aim: This study evaluated the immediate efficacy of low-level laser therapy on women reporting pain and diagnosed with temporomandibular dysfunction (TMD). Methods: Diode laser (GaAlAs) at 790 nm wavelength (infrared spectrum) was applied as experimental treatment. Irradiations of 1.5 J/cm2 were made at 4 points of the temporomandibular joint (TMJ) and of 3 J/cm2 at 3 points in the temporal muscle. An electromyographic (EMG) evaluation of the masseter and anterior temporal was done at the following intervals: before, immediately after, 5 min and 20 min after laser application. Results: Comparison of the electrical activity at the times of measurement revealed a statistically significant difference in masseter muscles before (P=0.025) and immediately after (P=0.013) LLLT. Conclusions: Both masseter and temporal muscles showed a reduction in the measured EMG activities at all times after LLLT, and the temporal muscle showed higher EMG activity than the masseter muscle at all the evaluation times. LLLT caused significant immediate relaxation of the masseter muscles.