Biomedical Science and Research Journals | Applied Transdérmic Photobiomodulator Therapy About the Primary Carotide Artery in Patients Under Hormonal Blockers and Dynude Disorders and Pathogenic Flora of Orofaringeo and Systemic Repercussions

 


Applied Transdérmic Photobiomodulator Therapy About the Primary Carotide Artery in Patients Under Hormonal Blockers and Dynude Disorders and Pathogenic Flora of Orofaringeo and Systemic Repercussions

Abstract


The purpose of this study is to categorize a transdermal anatomical location in the Primitive Carotid Artery (Common) for the use of modified Intrasvacular LASER Irradiation of Blood (ILIB). This study was conducted in twelve patients undergoing hormone blockers - Anastrozole / six and Tamoxifen / six and five patients without hormone therapy, all of which were performed in patients currently undergoing disease control therapy, where the site primary neoplastic were the mammary ducts (uni or bilateral). The noninvasive therapy of systemic LASER in the cervical region was motivated by the biological, technical and functional inactivity guided by the INCA (National Cancer Institute - Brazil) in order to avoid any manipulations on the same side of the operated breast, specifically the arm, due to to the possibilities of undesirable intercurrences that may cause clinical lowering and laboratory markers during the multidisciplinary treatment. Cancer patients treated with personalized protocols associated with the carotid region reduce the health-disease process related to morbidities as a consequence of the dysgeusias and imbalance of the oral microbiome. Adding to these benefits of photoenteral therapy (ILIB modified), systemic ones, promoted by the bifurcation of the primitive carotid artery in internal and external, triggering a homeostatic hormonal balance and vascularization of the anterior region of the face, correspondingly.

Keywords: Leadership; Teamwork; Scenario Awareness; Non-Technical Skills; Standards; Task Performance Analysis; Resurgence; Medical Emergency Team, Beside Author; Journal Searches

Introduction

The common carotid artery bifurcates to the upper edge of the thyroid cartilage. They are two (right and left) and have different origins: the right carotid artery originates from the brachiocephalic trunk, while the left carotid artery originates from the aortic artery. Each carotid artery divides into two, the internal and external ca rotid arteries (Figure 1) It is the carotids that palpate when we look for the wrists in the neck - and that the rescuers look for to evaluate the cardiac state of the unconscious patient. But what makes the cerebral circulatory system different is the famous Willis polygon. The internal / external arteries join in this circulatory structure at the base of the brain and it is from it that virtually all the arteries that irrigate the brain come out. Its main functions are to balance incoming blood pressures in the brain and to create alternative ways for the blood to keep circulating, even if one of the great arteries has a momentary interruption. However, if the pressure drops, the irrigation of the brain is compromised, or any of the great arteries fail, the unconsciousness is quickly generated. Unconsciousness is one of the mechanisms that the brain has to protect itself from poor blood supply, as it leads to imbalance; and being lying down ensures easier blood supply to the brain as well as reduced brain activity and thereby reduces the needs for blood and, of course, for glucose and oxygen. From the polygon of Willis, there are several arteries that penetrate deep into the brain, in both hemispheres, ensuring the formation of cerebrospinal fluid. It is the cerebrospinal fluid that delivers nutrients to the nerve cells in the brain and spinal cord, which means that the system that irrigates the brain is also responsible for nourishing the spinal cord. Another aspect to mention is that the cerebrospinal fluid is a filtrate of blood that reaches the brain, a kind of membrane, which creates the so-called blood-brain barrier, protecting the brain from toxic substances that may circulate in the blood.

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The hormones used in this Hospital, as a reference to “Breast Cancer”, impact on changes in the taste of food and change in oral flora leading these patients to reduce interest in food, which leads to decreased intake, resulting in nutritional deficit and weight loss. I reiterate that countless studies report on the side effects of hormone therapy and that high index of patients presents complaints of changes in taste. This is because the cytostatic agents are secreted in the saliva or they can diffuse in the plasma into the oral cavity, besides the Central Nervous System (Figure 4) that promotes the maintenance of the stimuli of the palate by contacting directly with taste receptors. An important etiology seems to be the inhibitory effect of the agent’s cytostatic effects on receptor cell mitosis, since in many patients, changes in taste resolve late when cell turnover is restored. Studies suggest that these drugs initially mentioned are associated with sensory alterations of the palate, however, comparative studies between the different agents and their impact on the alterations are scarce. Dysgeusia may persist after elimination of the drug by injury to the taste buds. While some studies show that changes in taste can start right after the start of treatment others show that they can start within ten weeks. During the cycles of these drugs the duration of this dysfunction can be from hours to weeks. And post-term chemotherapy and hormone-onset alteration may last up to a year, but there are cases “in this hospital” detected by the oncology dentistry department of patients who were 4 years old under dysgeusia dysfunction.

It should be reiterated that the preponderant function in these target protocols is to minimize this cytotoxic effect caused by these drugs against the side effects caused in the oral cavity through the low-cost and non-invasive photobiomodulator system, avoiding the imbalance of the buccal flora and destabilization of the sensory function of the palate.

Discussion

The increase in carotid artery flow after a Low Intensity Lasertherapy session was detected after irradiation on one side of the neck in 12 human patients, with increased blood flow on the irradiated side (63%) and increased cross-sectional diameter of the external carotid artery (69%) as objectively evaluated with color Doppler flowmetry [18]. Interestingly, on the non-irradiated side, blood flow and transverse volume (71% and 52%, respectively) were also observed, so that the blood flow on the non-irradiated side actually increased to a greater extent than on the irradiated side. These changes persisted for more than an hour before they began to fall back to the basic readings. Single photon emission tomography (SPECT) is a diagnostic technique by which a tracer of radioactive isotopes, the radionuclide, is injected into the individual. A camera-based scanner captures three-dimensional real-time tracer images in the cerebral arteries, and a computer image is then able to describe changes in 3-D or 2-D cerebral blood flow in any airplane.

Shows SPECT images compared between the onset and after a Low Intensity LASER session in the same patient (Figure 2) Increased cerebral blood flow was clearly visible throughout the brain after ILIB, both in the transverse (Figure 2a & Figure 2b) and sagittal (Figure 2c & 2d) planes. Table 1 shows the computer-calculated rate of increase of blood flow in two regions of interest (ROIs) of the brain compared between baseline and post-ILIB images.

This radiation emitted by Low Power LASERS (LBP) has demonstrated analgesic, anti-inflammatory and healing effects and is therefore widely used in the tissue repair process due to the low

energy densities used and wavelengths capable of penetrating in tissues [19]. Photobiomodulatory therapy performed at the Hospital of Cancer of Ribeirão Preto (16 female patients, resulting from Cancer, primary site of breast), the use of the cervical collar (anatomical positioner) in the primitive carotid artery was used for the application of transdermal phototherapy low-intensity (ILIB modified), red irradiance, EC device (DMC), net power emitting red LASER: 100 mW ± 20%, red LASER wavelength 660 nm ± 10 nm, continuous flow of 10 minutes which equals 60 JOULES total per session, periodicity of 1x per week, from October 2018 to April 2019, which produced significant data collections to the primary / biochemical (Table 2) and secondary / clinical effects (Table 3).

Currently, this Low Intensity LASER (LBI) is being used for the overall recovery of the patient in several specialties of the health area; and their responses are considered to be beneficial [20,21] in a variety of different modalities, due to their multifactorial effect [22]. Specifically, this mechanism when triggered in the craniofacial region is related to “neuronal repair and in neurogenesis, “not only in the formation of new brain cells but also in” synaptogenesis, “which is the formation of new connections between existing brain cells.

Therefore, the systemic and localized conditions during cancer treatment therapy contribute to the reduction of sensory capacity of the palate, causing transient or definitive dysgeusias, and in this niche of patients who use chemotherapeutic drugs and hormone- blockers these functions are altered often with a negative influence on organic and emotional well-being.

However, when it acts at the cellular level, low power LASER causes biochemical, bioelectric and bioenergetic modifications, influencing the increase of metabolism, cell proliferation and maturation, the amount of granulation tissue and the decrease of inflammatory mediators, stimulation of Neural checkpoints induce the production of hormones produced by neural endorphins - dopamine - serotonin - oxytocin, and the healing process [23,24]. And when the molecule is absorbed by light, it allows an increase in cellular metabolism, characterized by stimulation of photoreceptors in the mitochondrial respiratory chain, alterations in cellular ATP levels, release of growth factors and collagen synthesis [25].

This ILIB adjuvant function triggers an antioxidant system composed of enzymes, the main metallo-enzyme superoxide dismutase, or SOD ZnCu, is the largest antioxidant [26] we have and fifth volume enzyme in the human body. However, according to a recent review, evidence suggests that the enzymes catalaseperoxidase and ceruloplasmin also absorb red LASER which potentiates other enzymes, which obviously further increases the antioxidant property of these enzymes when irradiated in the ILIB process. Therefore, these therapeutic effects of light elucidate elucidate the side effects caused by the chemotherapeutic and hormone therapy cycles.

In the last three years, the oncological dentistry department of the Ribeirão Preto Cancer Hospital has investigated issues related to the use of low intensity LASER (photobiomodulation) for the recovery of dysgeusia that cause a relevant impact on the control of the oral microbiome, reflecting the reductions in xerostomia, hyposalivation, viral-fungal-bacterial infections and gradual return of palatal function that contribute in a timely manner to the reduction of the development of diseases associated with oncological treatments. Note that the authors (Table 3) identified a number of path ogens related to systemic diseases [27], showing the diversity of the oral microbial, opening space for colonization by microorganisms in other organs that in an analogical way may have an impact on the effect of carcinogenesis by producing carcinogenic agents potent Studies have recently revealed that the oral microbiome in cancer patients have a bacterial sensitivity and specificity above 90% [28].

Adjuvant functions of the LASER trigger an antioxidant system composed of enzymes, the main metallo-enzyme superoxide dismutase, or SOD ZnCu is the largest antioxidant [26] we have and fifth volume enzyme in the human body. However, according to a recent review, evidence is enzymes catalase peroxidase and ceruloplasmin also absorb red LASER which potentiates other enzymes, which obviously further potentiates the antioxidant properties of these enzymes when irradiated in this process [29]. These therapeutic effects of light can minimize the side effects caused by oncoterapies and the importance of the topic related to dysgeusia and its systemic reflexes from the microbioma of the oral cavity, it is interesting to elucidate that the main attention of the patients is the healthy longevity, which treated preventively or at other stages of the disease establishment, will have a considerable quality of life, as well as promote carcinogenic reduction of the tumor (any organs), balance of the microbiota, reduction of free radicals and increase of the blood supply in the craniofacial region.

The researches of the Photobiomodulation and the microbioma of human cancer appear as areas of extremely relevant and current research, within a multiprofessional context and reduction of morbidities.

Conclusion

Both subjective evaluation of objective tests, there is clearly an increase in local cerebral and systemic blood flow after ILIB carotid procedures (cervical collar) with pain relief (Behavioral Scale pain Rancho Los Amigos), improvement of biomarkers (blood count complete with platelets, Ca15-3), balance of the oral microbiome, reduction of dysgeusia (universal palate scale), control of arthralgias in the first months (Graph 1) and sensation of well-being. Besides oropharyngeal balance this therapy enabled patients with lower liver risk control transaminase (SGOT / SGPT), and other systemic complications buoyed by urea, neutrophils and platelets that remained at a good level. CA15-3 remained at low levels reducing the possibility of cancer recurrence. The group that did not receive the hormonal medication had a good response, and the groups that underwent hormonal therapy (Table 2) obtained results that were lower but relevant for reducing morbidities. The increase of the parasympathetic control is one of the main reasons suggested and would tend to be verified by the objective thermography, the Doppler flow meter and the SPECT evaluation (Figure 2). In addition to the verification of imaging findings in world literature, it should be reaffirmed that efficacy is demonstrated in the clinical / laboratory responses, in the pre-trans-post stages of cervical LASER applications and control groups during the last 2 years of protocols transdermal arteries in the region of the primitive cervical carotid artery mentioned in the text, causing promising impacts in this universe and expressive suspension of many intercurrences. The biological restoring these individuals in laser therapy and consequently returning to social life is mediated by clinical and laboratory functions through continuous monitoring of biomarkers, primary and secondary effects triggering a collective welfare in the harvest cancers.

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