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      Análise histológica em tecido epitelial sadio de ratos Wistar (in vivo) irradiados com diferentes intensidades do ultrassom Translated title: Histological analysis of healthy epithelium of Wistar rats in vivo irradiated with different intensities of therapeutic ultrasound

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          Abstract

          CONTEXTUALIZAÇÃO: O Ultrassom (US) é um dos recursos físicos amplamente utilizado e pesquisado nos tratamentos de fisioterapia. Sabe-se que diante de uma escassa literatura sobre efeitos do US em tecidos sadios, muitos profissionais fisioterapeutas acabam realizando aplicações infundadas de métodos e parâmetros. OBJETIVO: Avaliar possíveis alterações histológicas e morfométricas do tecido sadio in vivo de ratos Wistar irradiados com diferentes intensidades de US. MÉTODOS: Trinta ratos da linhagem Wistar, distribuídos aleatoriamente em cinco grupos de seis animais cada foram tratados na região dorsal do lado direito numa área de 4cm². O lado esquerdo serviu como controle. O tratamento foi feito durante quatro dias com 2 minutos de irradiação. Verificou-se a intensidade de saída com dosímetro de precisão antes das aplicações. Analisou-se a histologia e a morfometria por meio do software Image Tool. RESULTADOS: Observou-se um discreto infiltrado inflamatório e adelgaçamento das fibras da derme, principalmente dos grupos irradiados com 1.5 e 2W/cm². Notou-se também um aumento na espessura da epiderme nas amostras dos animais irradiados. Para avaliar os resultados quantitativos, utilizou-se como análise estatística ANOVA one way e o teste post hoc de Tukey. Na espessura da epiderme, obtiveram-se diferenças significativas entre grupo controle e os grupos irradiados com 1.0, 1.5 e 2.0W/cm². CONCLUSÃO: Sob ação do US nas doses maiores houve alterações na epiderme e derme, respectivamente, o aumento da espessura e proliferação com adelgaçamento das fibras colágenas, o que alerta para possíveis implicações do uso do US em estética.

          Translated abstract

          BACKGROUND: Ultrasound (US) is a widely used and studied resource for physical therapy treatments. Given the scarcity of studies on the effects of US on healthy tissue, many physical therapy professionals make unfounded decisions regarding its methods and parameters of application. OBJECTIVES: The possible histological and morphometric changes in the healthy tissue of Wistar rats in vivo irradiated with different intensities of US were evaluated. METHODS: Thirty Wistar rats, randomly distributed among five groups of six animals each, were treated on the right side of the dorsal region, over an area of 4 cm². The left side served as a control. The treatment was applied over a four-day period, with two mins. of daily irradiation. The output intensity was checked using a precision dosimeter before the applications. Histological and morphometric analyses were performed using the Image Tool software. RESULTS: There were slight inflammatory infiltration and thinning of the dermis fibers, particularly in the groups irradiated with 1.5 and 2 W/cm². There was also thickening of the epidermis in the samples from the irradiated animals. To evaluate the quantitative results, the statistical analyses consisted of one-way ANOVAs with the post-hoc Tukey tests. There were significant differences in epidermis thicknesses between the control group and the groups irradiated with 1.0, 1.5 and 2.0 W/cm². CONCLUSIONS: Higher doses of US produced changes in the epidermis and dermis, i.e. increased thickness and collagen fiber thinning and proliferation, respectively. These results serve as a warning of the possible implications of therapeutic ultrasound use in esthetics.

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          Most cited references24

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          Therapeutic applications of ultrasound.

          Therapeutic applications of ultrasound predate its use in imaging. A range of biological effects can be induced by ultrasound, depending on the exposure levels used. At low levels, beneficial, reversible cellular effects may be produced, whereas at high intensities instantaneous cell death is sought. Therapy ultrasound can therefore be broadly divided into "low power" and "high power" applications. The "low power" group includes physiotherapy, fracture repair, sonophoresis, sonoporation and gene therapy, whereas the most common use of "high power" ultrasound in medicine is probably now high intensity focused ultrasound. Therapeutic effect through the intensity spectrum is obtained by both thermal and non-thermal interaction mechanisms. At low intensities, acoustic streaming is likely to be significant, but at higher levels, heating and acoustic cavitation will predominate. While useful therapeutic effects are now being demonstrated clinically, the mechanisms by which they occur are often not well understood.
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            What is ultrasound?

            This paper is based on material presented at the start of a Health Protection Agency meeting on ultrasound and infrasound. In answering the question 'what is ultrasound?', it shows that the simple description of a wave which transports mechanical energy through the local vibration of particles at frequencies of 20 kHz or more, with no net transport of the particles themselves, can in every respect be misleading or even incorrect. To explain the complexities responsible for this, the description of ultrasound is first built up from the fundamental properties of these local particle vibrations. This progresses through an exposition of the characteristics of linear waves, in order to explain the propensity for, and properties of, the nonlinear propagation which occurs in many practical ultrasonic fields. Given the Health Protection environment which framed the original presentation, explanation and examples are given of how these complexities affect issues of practical importance. These issues include the measurement and description of fields and exposures, and the ability of ultrasound to affect tissue (through microstreaming, streaming, cavitation, heating, etc.). It is noted that there are two very distinct regimes, in terms of wave characteristics and potential for bioeffect. The first concerns the use of ultrasound in liquids/solids, for measurement or material processing. For biomedical applications (where these two processes are termed diagnosis and therapy, respectively), the issue of hazard has been studied in depth, although this has not been done to such a degree for industrial uses of ultrasound in liquids/solids (sonar, non-destructive testing, ultrasonic processing etc.). However, in the second regime, that of the use of ultrasound in air, although the waves in question tend to be of much lower intensities than those used in liquids/solids, there is a greater mismatch between the extent to which hazard has been studied, and the growth in commercial applications for airborne ultrasound.
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              Therapeutic ultrasound in soft tissue lesions.

              Therapeutic ultrasound is one of the most common treatments used in the management of soft tissue lesions, which constitute the majority of rheumatic complaints. Although many laboratory-based research studies have demonstrated a number of physiological effects of ultrasound upon living tissue, there is remarkably little evidence for benefit in the treatment of soft tissue injuries. This may be related to several confounding factors, including technical variables, the complexity and variety of underlying pathologies in soft tissue lesions, methodological limitations of clinical studies, or true lack of effect. In this review the scientific basis for the use of therapeutic ultrasound in soft tissue lesions and the existing evidence relating to its clinical effect are detailed.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbfis
                Brazilian Journal of Physical Therapy
                Braz. J. Phys. Ther.
                Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (São Carlos )
                1809-9246
                April 2010
                : 14
                : 2
                : 114-120
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade Estadual Paulista Brazil
                [4 ] Universidade Federal de São Carlos Brazil
                Article
                S1413-35552010000200005
                95b18308-cc35-45e5-828d-c97ed67f5644

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1413-3555&lng=en
                Categories
                ORTHOPEDICS
                REHABILITATION

                Orthopedics,Physiotherapy
                Therapeutic ultrasound,dosimetry,side effects,tissue damage,ultrassom terapêutico,dosimetria,efeitos colaterais,danos teciduais

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