Importance: Bothrops venom acts almost immediately at the bite site and causes tissue damage.
Objective: To investigate the feasibility and explore the safety and efficacy of low-level laser therapy (LLLT) in reducing the local manifestations of B atrox envenomations.
Design, Setting, And Participants: This was a double-blind randomized clinical trial conducted at Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, Brazil. A total of 60 adult participants were included from November 2020 to March 2022, with 30 in each group. Baseline characteristics on admission were similarly distributed between groups. Data analysis was performed from August to December 2022.
Intervention: The intervention group received LLLT combined with regular antivenom treatment. The laser used was a gallium arsenide laser with 4 infrared laser emitters and 4 red laser emitters, 4 J/cm2 for 40 seconds at each application point.
Main Outcomes And Measures: Feasibility was assessed by eligibility, recruitment, and retention rates; protocol fidelity; and patients' acceptability. The primary efficacy outcome of this study was myolysis estimated by the value of creatine kinase (U/L) on the third day of follow-up. Secondary efficacy outcomes were (1) pain intensity, (2) circumference measurement ratio, (3) extent of edema, (4) difference between the bite site temperature and that of the contralateral limb, (5) need for the use of analgesics, (6) frequency of secondary infections, and (7) necrosis. These outcomes were measured 48 hours after admission. Disability assessment was carried out from 4 to 6 months after patients' discharge. P values for outcomes were adjusted with Bonferroni correction.
Results: A total of 60 patients (mean [SD] age, 43.2 [15.3] years; 8 female individuals [13%] and 52 male individuals [87%]) were included. The study was feasible, and patient retention and acceptability were high. Creatine kinase was significantly lower in the LLLT group (mean [SD], 163.7 [160.0] U/L) 48 hours after admission in relation to the comparator (412.4 [441.3] U/L) (P = .03). Mean (SD) pain intensity (2.9 [2.7] vs 5.0 [2.4]; P = .004), circumference measurement ratio (6.6% [6.6%] vs 17.1% [11.6%]; P < .001), and edema extent (25.8 [15.0] vs 40.1 [22.7] cm; P = .002) were significantly lower in the LLLT group in relation to the comparator. No difference was observed between the groups regarding the mean difference between the bite site temperature and the contralateral limb. Secondary infections, necrosis, disability outcomes, and the frequency of need for analgesics were similar in both groups. No adverse event was observed.
Conclusions And Relevance: The data from this randomized clinical trial suggest that the use of LLLT was feasible and safe in a hospital setting and effective in reducing muscle damage and the local inflammatory process caused by B atrox envenomations.
Trial Registration: Brazilian Registry of Clinical Trials Identifier: RBR-4qw4vf.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696517 | PMC |
http://dx.doi.org/10.1001/jamainternmed.2023.6538 | DOI Listing |
J Diabetes Sci Technol
December 2024
Clinical Diabetes, Appetite and Metabolism Laboratory, Garvan Institute of Medical Research, Sydney, NSW, Australia.
Introduction: Two phase 3 randomized controlled studies (ADJUNCT ONE (Clinicaltrials.gov: NCT01836523), ADJUNCT TWO (Clinicaltrials.gov: NCT02098395)) evaluated liraglutide (1.
View Article and Find Full Text PDFJ Cosmet Dermatol
December 2024
Department of Plastic Surgery, Affiliated Calmette Hospital of Kunming Medical University, Kunming, China.
Background: The Yunnan-Guizhou Plateau's high-altitude setting is characterized by intense solar ultraviolet radiation, a significant environmental stressor that frequently leads to skin barrier damage. This damage presents clinically as erythema, itching, and desquamation, underscoring the need for effective reparative interventions.
Aims: The objective of this study was to assess the therapeutic efficacy of a novel treatment protocol that integrates non-crosslinked hyaluronic acid (HA) injection with microneedle application of human epidermal growth factor (hEGF) for the restoration of skin barrier function in regions of high altitude.
Orthod Craniofac Res
December 2024
Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland.
The primary objective was to systematically assess the prevalence, incidence and risk factors of WSLs with orthodontic treatment. The secondary objective was to compare the prevalence of WSLs between conventional fixed appliances (CFA) and other appliances, as well as with no treatment. PubMed, Scopus, Web of Science, LILACs, Virtual Health Library and Cochrane CENTRAL were searched.
View Article and Find Full Text PDFMed Decis Making
December 2024
Department of Social & Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA.
Background: In the United States, human papillomavirus (HPV) vaccination among 27- to 45-y-olds (mid-adults) is recommended based on shared clinical decision making with a health care provider. We developed a patient decision aid tool to support the implementation of this mid-adult HPV vaccination guideline. The purpose of this study was to evaluate the effect of a patient decision aid tool for HPV vaccination, HPV DECIDE, compared with an information fact sheet among mid-adults who have not received the HPV vaccine.
View Article and Find Full Text PDFMol Med Rep
March 2025
School of Basic Medicine, Anhui Medical University, Hefei, Anhui 230032, P.R. China.
The incidence of hyperuricemia has increased recently, posing a serious threat to public health. Hyperuricemia is associated with an increased risk of gout, chronic kidney disease (CKD), obesity, metabolic syndrome, type 2 diabetes mellitus, hypertension, hypertriglyceridaemia, metabolic dysfunction‑associated steatotic liver disease, acute kidney injury, coronary heart disease and cardiovascular disease (CVD). These diseases are commonly accompanied by varying degrees of kidney damage.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!