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The role of decompressive craniectomy in the treatment of severe posttraumatic cerebral swelling remains quite a controversial issue. To the best of our knowledge, there is no study demonstrating the effect of decompressive craniectomy on cerebral blood flow (CBF) velocity by means of transcranial Doppler sonography (TCD). We present two patients who developed traumatic brain swelling and uncontrollable intracranial hypertension with coma and signs of transtentorial herniation. One patient underwent bifrontal, while the second, unilateral, frontotemporoparietal decompressive craniectomy with dural expansion. In both patients, TCD examinations were performed immediately before and after surgery to study the cerebral hemodynamic changes related to the operations. Pre and postoperative TCD examinations demonstrated a significant increase in blood flow velocity in the intracranial arteries in both subjects. In conclusion, our cases suggest that decompressive craniectomy with dural expansion may result in elevation of CBF velocity in patients with massive brain swelling. The increase in CBF velocity appears to occur not only in the decompressed hemisphere, but also on the opposite side.

Background: Photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) are used to reduce neck pain., Objective: To investigate the immediate and 1-month post-treatment effects of 10 treatment sessions of PBM and TENS delivered over 2 weeks on pain intensity in individuals with neck pain., Methods: Individuals with neck pain were randomized into four groups: PBM+TENS, PBM, TENS, and Sham., Primary Outcome: pain intensity at rest., Secondary Outcomes: pain intensity during movement, pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), cervical range of motion (ROM), psychosocial factors, drug intake for neck pain, and global perceived effect (GPE). All outcome assessments were made pre- and post-treatment. Mean differences and 95 % confidence intervals were calculated for between-group comparisons., Results: A total of 144 participants were recruited. No significant between-group difference was observed for pain intensity at rest, TS, CPM, ROM, psychosocial factors, and drug intake. The PBM+TENS showed a reduction in pain intensity during movement and GPE compared to the PBM (MD: 1.0 points; 95 % CI: 0.0, 2.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) and Sham (MD: 2.0 points; 95 % CI: 1.0, 3.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) groups. PBM+TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase distant PPT compared to other groups., Conclusions: The use of PBM or TENS was not effective for reducing pain intensity at rest. The combination of PBM and TENS was effective in improving pain intensity during movement, local hyperalgesia, and the GPE. TENS reduced local and distant hyperalgesia., Competing Interests: Declaration of competing interest We hereby certify that no party with a direct interest in the results of the research that supports this article has or will confer benefits on us or any organization with which we are affiliated., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Platelet rich plasma and ozone therapy have been suggested in the clinical setting as promising and adjuvant therapies for managing the symptoms related to the facial aging. However, there is a lack of evidence about the effects of combining both therapies on rejuvenation. Thus, the aim of the present study was to evaluate and to compare the safety and efficacy of both therapies in facial aging. A single-center prospective pilot study was conducted. Female participants, aged 40 to 60 years, were randomized into 2 groups: participants received the platelet rich plasma treatment (PRP); participants received the therapy with platelet rich plasma associated with ozone therapy (PRPOT). Interventions were performed using the facial intradermal technique in 42 pre-established points, for 4 sessions with an interval of 15 days between them. After analyses performed using photographic records, assessment of frontal, periorbital, nasolabial and marionette wrinkles (Wrinkle Assessment Scale), self-esteem assessment (Brazilian Version of Rosenberg's Self-Esteem Scale) and assessment of patient satisfaction (FACE-Q) can be suggested that the platelet rich plasma protocol performed in the present study, as well as its association with volume-controlled ozone therapy, proved to be safe and potentially promising modalities in the treatment of facial aging.

Purpose: Characterize heart rate and cardiac autonomic response to painful stimulus on neck pain., Methods: Twenty-five individuals with neck pain and 25 healthy subjects were included. Heart rate variability and heart rate were assessed in the conditioned pain modulation test at pretest rest, during testing and in recovery. Heart rate variability indices were obtained using linear and nonlinear methods., Results: No significant differences were observed between groups regarding heart rate and the linear methods (p > 0.05). However, significant difference was observed between groups regarding nonlinear methods (standard deviation of the instantaneous variability of beat-to-beat interval variability, p = 0.005) CONCLUSIONS: Individuals with chronic neck pain showed autonomic responses similar to those of their healthy counterparts during the conditioning stimulus., Competing Interests: Declaration of competing interest We hereby certify that no party with a direct interest in the results of the research that supports this article has or will offer benefits to us or any organization with which we are affiliated., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: Cryolipolysis (CLL) is a widely employed noninvasive procedure for body fat reduction. It operates by inducing cooling, leading to the crystallization of cytoplasmic lipids, loss of cellular integrity, and apoptosis/necrosis of adipocytes, accompanied by local inflammation. Ongoing discussions revolve around CLL's potential to transform white adipocytes into brown adipocytes, potentially yielding more significant effects compared to alternative procedures., Objective: Thus, this randomized, blinded clinical study aimed to investigate the effects of CLL on adipose tissue and elucidate the mechanisms involved in its application and capacity for adipocyte conversion., Methodology: Tissue samples from six patients were assessed at intervals of 45, 60, and 90 days following the application of the CLL protocol during abdominoplasty surgeries., Results: The samples underwent immunohistochemical analyses targeting various markers, revealing higher expression of PPAR-gamma, PPAR-alpha, and UCP-1 markers in CLL-treated samples., Conclusion: Therefore, the present study suggests that CLL has the ability to intervene in adipocyte conversion., (© 2024 Wiley Periodicals LLC.)

Background: In recent years, aesthetic procedures aiming at body remodeling and have grown exponentially. Cryolipolysis (CLL) has stood out as a noninvasive resource that acts directly on the subcutaneous adipose tissue promoting a significant reduction of adipose tissue through of cooling that could lead to the crystallization cytoplasmic lipids, loss of cellular integrity, apoptosis/necrosis of adipocytes, and local inflammation, producing selective loss of adipose tissue. Thus, the objective of the present study was to evaluate the effects of a specific technique of CLL application on the inflammatory reactions of the target tissue in different post-application times., Methods: This is a randomized, blind clinical study that evaluated the tissue sample of six patients after 45, 60, and 90 days of an innovative protocol for the application of CLL, with samples collected through abdominoplasty surgeries. The samples were evaluated by immunohistochemical analyses of several markers., Results: A significantly greater increase in fibroblasts was observed at 45 days and greater phagocytic action at 60 days. Regarding the apoptosis process, the expression of caspase 3 and cleaved caspase 3 markers varied at different times, with cleaved caspase 3 being higher at 45 and 90 days after CLL application., Conclusion: The protocol of the CLL presented in this study was able to induce inflammatory responses in addition to confirming the selective apoptotic action at the different times studied., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: The plasma jet is a non-surgical and minimally invasive procedure that acts by heating the superficial region of the skin, providing rejuvenation of the region., Objective: We sought to compare the clinical and histological effects of direct plasma jet versus electrocarbonization without plasma in the treatment of wrinkles in the upper palpebral region., Methods: This is a clinical trial in which 20 volunteers participated and divided into two groups: electrocarbonization (EG) and plasma jet (JPG), which were clinically evaluated before and after treatment through evaluation protocols, photographs, and questionnaires. Three treatment sessions were performed in the upper eyelid region with an interval of 30 days. After the treatment, a surgical procedure of upper blepharoplasty was performed on two volunteers to remove a skin fragment and later histological analysis., Results: The JPG showed better clinical responses in rejuvenation. The EG promoted an increase in the number of fibroblasts, the number of blood vessels and the amount of inflammation. The JPG showed an increase in the number of fibroblasts and blood vessels. It was observed that the JPG generated activation of T lymphocytes (CD3), macrophages (CD68), and plasmocytes (CD138); in addition to reducing the number of positive cells for CD57 (NK cells). The satisfaction analysis shows that 100 percent in the JPG considered themselves satisfied with the treatment., Conclusion: We verified that in comparison with electrocarbonization, the use of a direct plasma jet promoted tissue improvement at the histological level, in addition to fewer adverse reactions., Competing Interests: DISCLOSURES: The authors report no conflicts of interest relevant to the content of this article., (Copyright © 2024. Matrix Medical Communications. All rights reserved.)

Photobiomodulation (PBM) has been proposed as a strategy to improve the regenerative capacity of human adipose-derived stem cells (hASCs). Yet, this effect has been proved in 2D culture conditions. To analyze the effect of different doses of laser irradiation (660 nm) with different levels of energy (1 J, 2 J and 6 J) on hASCs cultured at 2D and 3D conditions. We used gellan gum spongy-like hydrogels as a biomaterial to 3D culture hASCs. Different doses (1-7 daily irradiations) and energy levels (1-6 J) of PBM were applied, and the metabolic activity, viability, proliferation, and release of ROS and IL-8 was evaluated up to 7 days. In 3D, cell proliferation increased at high energy (6 J) and after a single dose of irradiation, while in 2D, metabolic activity and proliferation was enhanced only after 3 doses and independently of the energy. More than 1 dose was needed to promote ROS secretion both in 2D and 3D culture conditions. Interestingly, a decrease of IL-8 secretion was detected only in 3D after 3-7 daily irradiations. Overall, hASCs response to PBM was not only dependent on the energy level and the number of applied stimuli, but also on the in vitro culture conditions., (© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

The purpose of the cross-sectional study was to identify patterns of modifiable lifestyle behaviors and examine the relationship between sociodemographic characteristics and distinct lifestyle behaviors. The data were gathered from the National Health Survey 2019, a study that included adults with diabetes. Four domains of lifestyle behaviors were used to define these behaviors: smoking, alcohol consumption, physical activity, and diet. The association between patterns of lifestyle behaviors and variables of interest was assessed using multinomial regression analysis. The three lifestyle patterns identified were: Class 1, referred to as "unhealthy diet," comprised 17.0% of the sample and was characterized by unhealthy eating habits; Class 2 (less active and insufficient fruit and vegetable intake) represented 71.2% of the sample; Class 3 referred to as "low risk" (11.8%) is characterized by a lower probability of engaging in most risky behaviors. A person over 45 years of age with little or no education and no health care coverage was less likely to be a member of Class 1. Male individuals who do not attend a doctor regularly exhibited more chances of belonging to Class 2. Mixed-race individuals aged 45 years or more with a low level of education have a lower chance of belonging to this class.

The use of electronic cigarettes (e-cigarettes) persists in Brazil, despite restrictions on sales, imports, and advertising. This study aimed to identify the prevalence of e-cigarette use and user profiles among university students. This cross-sectional study used a convenience sample of 3083 university students (female = 2253, male = 830; M =26.1; SD =8.43) who completed an online survey. We employed logistic regression models and network analysis to determine the profile of e-cigarette users. The prevalence of e-cigarette use in the past year was 12.2% ( n =377). Men, single individuals, Caucasians, secular individuals, and non-heterosexual individuals were more likely to engage in e-cigarette use. Intense use of alcohol, tobacco products, and illicit drugs increased the likelihood of e-cigarette use. Brazilian college students continue to use electronic cigarettes despite the prohibition. The pattern of alcohol abuse and tobacco product use among e-cigarette users is concerning. These risky behaviors render young and highly educated individuals targets for public policies to control and regulate electronic cigarettes in the country., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background and Aims: Many new digital gambling-like activities such as loot boxes, esports betting, skin betting, and token wagering have recently emerged and grown in popularity. This scoping review aimed to: (a) synthesize the existing empirical research literature on gambling-like activities and their associations with gambling and video gaming behaviors, including problem gambling and video gaming; (b) identify sociodemographic, psychological, and motivational factors associated with engagement in gambling-like activities; and (c) identify research gaps and areas for further research., Methods: A systematic search of Ovid, Embsco, and ProQuest databases and Google Scholar was conducted in May 2021 and last updated in February 2022. The search yielded a total of 2,437 articles. Articles were included in the review if they were empirical studies that contained quantitative or qualitative results regarding the relationship between gambling-like activities and gambling or gaming., Results: Thirty-eight articles met inclusion criteria and were included in the review. Overall, the review results suggest that all forms of gambling-like activities were positively associated with gambling and gaming with small to medium effects. Gambling-like activity participation was also positively associated with mental distress and impulsivity. Gaps identified included a lack of inquiry into skin betting and token wagering, a lack of diversity in the research methods (i.e., mainly cross-sectional surveys), and a paucity of research that includes more ethnically, culturally, and geographically diverse populations., Discussion: Longitudinal studies with more representative samples are needed to examine the causal link between gambling-like activities and gambling and video gaming.

The Smartphone Addiction Inventory - Short Form (SPAI-SF) is shorter version (10 items) of the original version of SPAI (26 items). In this study, we aimed to: (i) adapt and test the internal structure of the SPAI-SF, using confirmatory factor analysis (CFA), multigroup confirmatory factor analysis (MGCFA), and network analysis; (ii) analyze the internal consistency, temporal stability, criterion, predictive and construct validities of the SPAI-SF. A total of 392 adolescents (M = 12.76; SD = 1.00) completed the following measures: demographic questionnaire, SPAI-SF, Smartphone Addiction Scale - Short Version (SAS-SV), and the Internet Addiction Test (IAT). The CFA showed good fit indices with the original four factors, and MGCFA indicated measurement invariance for gender. Network analysis provided an understanding of the core symptoms of problematic smartphone use (PSU) for both boys and girls. The intraclass correlation coefficient (ICC) was 0.865 (95% CI: 0.841 - 0.887) and indicated a robust temporal stability. The instrument demonstrated acceptable overall reliability measured by Cronbach's alpha and McDonald's Omega criteria (α = 0.722; ω = 0.725) and did not show floor and ceiling effects. The scale's significant correlations demonstrated convergent and criterion validities of the SPAI-SF with SAS-SV, IAT, and Smartphone usage data. The SPAI-SF is a reliable instrument to detect PSU in adolescents., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The objective of this study is to conduct a systematic review and meta-analysis to assess the effect of psychosocial interventions in reducing problematic Internet use (PIU), anxiety, and depression symptoms in a sample of people. This review was registered on the PROSPERO database (CRD42020181912) and a total of 15 studies were included. Analyses of the effect of the interventions were conducted based on the standardized mean difference of the studied outcomes (PIU, anxiety, and depression). Most studies reported a positive effect of psychosocial interventions on reducing symptoms of PIU, depression, and anxiety among people with PIU. However, only one detected a robust effect in reducing symptoms of anxiety. For depression, this effect was more modest, and there was no difference between the different modalities of psychosocial interventions. The results suggest that psychosocial interventions are effective in reducing both symptoms of PIU and co-occurring symptoms of depression and anxiety in individuals with PIU., Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-022-00846-6., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

Text messaging is the primary form of technology-mediated interpersonal contact and the most carried out activity on cell phones. Despite its advantages, text messaging is not exempt from risks. The present paper aimed to validate and expand the psychometric properties of the Self-perception of Text-message Dependency Scale (STDS) in a Brazilian sample of adult internet users. In this cross-sectional study, we recruited a convenience sample of Brazilian internet users aged 18 and over. A total of 1,642 ( M age  = 38.6, SD  = 13.5; 73% female) participants completed the STDS, the Mobile Phone Problem Usage Scale-27 (MPPUS), and the Problematic Internet Use Questionnaire - Short form - 9 questionnaires (PIUQ-SF-9). Multigroup confirmatory factor analysis showed measurement invariance for gender and age. Internal consistency was high when accessed by both McDonalds' Omega and Cronbach's alpha. Network Analysis provided insights into the core symptoms of problematic text messaging. Convergent validity of the STDS was demonstrated by the subscale's correlation with MPPUS and PIUQ-SF-9. Due to its expanded psychometric properties and brevity, the STDS can be used in more comprehensive investigations about other excessive technology-related behaviors, such as problematic smartphone and internet use, allowing a better understanding of the mechanisms involved in problematic technology use., Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-02957-8., Competing Interests: Conflicts of InterestThe authors declare that they have no conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

In general, bone fractures are able of healing by itself. However, in critical situations such as large bone defects, poor blood supply or even infections, the biological capacity of repair can be impaired, resulting in a delay of the consolidation process or even in non-union fractures. Thus, technologies able of improving the process of bone regeneration are of high demand. In this context, ceramic biomaterials-based bone substitutes and photobiomodulation (PBM) have been emerging as promising alternatives. Thus, the present study performed a systematic review targeting to analyze studies in the literature which investigated the effects of the association of ceramic based bone substitutes and PBM in the process of bone healing using animal models of bone defects. The search was conducted from March and April of 2019 in PubMed, Web of Science and Scopus databases. After the eligibility analyses, 16 studies were included in this review. The results showed that the most common material used was hydroxyapatite (HA) followed by Biosilicate associated with infrared PBM. Furthermore, 75% of the studies demonstrated positive effects to stimulate bone regeneration from association of ceramic biomaterials and PBM. All studies used low-level laser therapy (LLLT) device and the most studies used LLLT infrared. The evidence synthesis was moderate for all experimental studies for the variable histological analysis demonstrating the efficacy of techniques on the process of bone repair stimulation. In conclusion, this review demonstrates that the association of ceramic biomaterials and PBM presented positive effects for bone repair in experimental models of bone defects., (© 2021 The Authors. Journal of Biomedical Materials Research Part A published by Wiley Periodicals LLC.)

Purpose: To evaluate and compare two types of different scaffolds in critical bone defects in rats., Methods: Seventy male Wistar rats (280 ± 20 grams) divided into three groups: control group (CG), untreated animals; biomaterial group 1 (BG1), animals that received the scaffold implanted hydroxyapatite (HA)/poly(lactic-co-glycolic) acid (PLGA); and biomaterial group 2 (BG2), animals that received the scaffolds HA/PLGA/Bleed. The critical bone defect was induced in the medial region of the skull calotte with the aid of an 8-mm-diameter trephine drill. The biomaterial was implanted in the form of 1.5 mm thick scaffolds, and samples were collected after 15, 30 and 60 days. Non-parametric Mann-Whitney test was used, with the significance level of 5% (p ≤ 0.05)., Results: Histology revealed morphological and structural differences of the neoformed tissue between the experimental groups. Collagen-1 (Col-1) findings are consistent with the histological ones, in which BG2 presented the highest amount of fibers in its tissue matrix in all evaluated periods. In contrast, the results of receptor activator of nuclear factor kappa-Β ligand (Rank-L) immunoexpression were higher in BG2 in the periods of 30 and 60 days, indicating an increase of the degradation of the biomaterial and the remodeling activity of the bone., Conclusions: The properties of the HA/PLGA/Bleed scaffold were superior when compared to the scaffold composed only by HA/PLGA.

Objective: Given the complex and unclear etiology of neck pain, it is important to understand the differences in central sensitization as well as psychosocial factors in individuals with chronic neck pain and healthy controls. The purpose of this study was to benchmark differences in central sensitization, psychosocial factors, and range of motion between people with nonspecific chronic neck pain and healthy controls and to analyze the correlation between pain intensity, neck disability, and psychosocial factors in people with chronic neck pain., Methods: Thirty individuals with chronic neck pain and 30 healthy controls were included in this case-control study. Outcome measures were as follows: central sensitization (pressure pain threshold, temporal summation, and conditioned pain modulation), psychosocial factors (depressive symptoms, pain catastrophizing, and quality of life), and active cervical range of motion., Results: People with neck pain had lower local pressure pain threshold, a decrease in conditioned pain modulation, more depressive symptoms, greater pain catastrophizing, lower quality of life, and reduced range of motion for neck rotation when compared with healthy controls. In people with neck pain, moderate correlations were observed between pain intensity and quality of life (ρ = -0.479), disability and pain catastrophizing (ρ = 0.379), and disability and quality of life (ρ = -0.456)., Conclusions: People with neck pain have local hyperalgesia, impaired conditioning pain modulation, depressive symptoms, pain catastrophizing, low quality of life, and reduced active range of motion during neck rotation, which should be taken into account during assessment and treatment., Impact: This study shows that important outcomes, such as central sensitization and psychosocial factors, should be considered during assessment and treatment of individuals with nonspecific chronic neck pain. In addition, pain intensity and neck disability are correlated with psychosocial factors., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Collagen (Col) from marine organisms has been emerging as an important alternative for commercial Col and it has been considered highly attractive by the industry. Despite the positive effects of Col from marine origin, there is still limited understanding of the effects of this natural biomaterial in the process of wound healing in animal studies. In this context, the purpose of this study was to perform a systematic review of the literature to examine the effects of Col from different marine species in the process of skin tissue healing using experimental models of skin wound. The search was carried out according to the orientations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the descriptors of the Medical Subject Headings (MeSH) were defined: "marine collagen," "spongin," "spongin," "skin," and "wound." A total of 42 articles were retrieved from the databases PubMed and Scopus. After the eligibility analyses, this review covers the different marine sources of Col reported in 10 different papers from the beginning of 2011 through the middle of 2019. The results were based mainly on histological analysis and it demonstrated that Col-based treatment resulted in a higher deposition of granulation tissue, stimulation of re-epitalization and neoangiogenesis and increased amount of Col of the wound, culminating in a more mature morphological aspect. In conclusion, this review demonstrates that marine Col from different species presented positive effects on the process of wound skin healing in experimental models used, demonstrating the huge potential of this biomaterial for tissue engineering proposals.

This study evaluated the prevalence of Internet addiction (IA) and its association with negative psychological symptoms in Brazilian adults. A network analysis was conducted to estimate specific variables and their expected influence on IA. In this cross-sectional study, 15,476 adults (M age  = 37.5, SD = 9.59) completed an open web-based survey. Three questionnaires were used: the Internet Addiction Test (IAT), Depression Anxiety and Stress Scale (DASS-21) and Satisfaction With Life Scale (SWLS). Based on IAT scores, participants were classified as No-Risk user (NRU), Low-Risk user (LRU) or High-Risk user (HRU). We observed that 4.8% of the participants were classified in the HRU group. In addition, their risk for severe symptoms of depression was 10 times higher and, for anxiety, seven times higher than that in the NRU group (p < .001). Time spent using smartphones was also significantly higher in the HRU group (M hours  = 5.1, p < .001). The main factors associated with IA were depression, gender and anxiety, but the variable "having children" was the most influential in the IA network. These findings suggest that psychiatric symptoms are the main factors associated with IA among the adult population., (© 2020 International Union of Psychological Science.)

This study aimed to evaluate the effects of the FunFRIENDS protocol on anxiety symptoms, internalizing problems and prosocial behavior in 4- to 5-year old children. Participated of this study 43 children with an allocation ratio of 1:1 between groups (Intervention Group [IG], N = 21; Control Group [CG], N = 22) from a public school in the city of Sao Paulo participated in the study. Behaviors were evaluated by using standardized questionnaires (PAS, CBCL, SDQ, SCBE) assessing the behavioral profile of the children at three different periods; baseline (T0), one month (T1) and three months (T2) after the intervention. It was observed a reduction in the intensity of anxiety symptoms in the IG after the intervention but with no significant effect. Overall, there were no significant differences between the IG and the CG in most behaviors on all periods evaluated. On both Intention-to-Treat analyses also it was not detected significant effects of the intervention. This is the first Brazilian study evaluating the effects of FunFRIENDS program and the implications of these findings are discussed and its significance for future research.

The objectives of this study were to analyze the psychometric properties of the Smartphone Addiction Scale - Short Version (SAS-SV) as follows: (i) the factor structure of the SAS-SV using different statistical methods; (ii) the evidence of convergence; (iii) the temporal stability of the SAS-SV; and (iv) predictive SAS-SV validity. A total of 451 adolescents participated in this study (age M = 13.1; SD = 1.22) by completing a sociodemographic questionnaire (including items evaluating the perception of smartphone use), the Internet Addiction Test (IAT), and the SAS-SV. It was found that 53.2% demonstrated problematic smartphone use. The SAS-SV showed good reliability (α = 0.81; ω = 0.78), and all of its items were kept. The network analysis indicated that the items evaluating the withdrawal and preoccupation symptoms had the greatest influence on the network. The intraclass correlation coefficient was 0.846 and indicated good temporal stability of the SAS-SV 20-30 days after the first application. The receiver operating characteristic (ROC) curve analysis indicated 33 points as the best cutoff for the SAS-SV (AUC = 0.739; sensitivity = 65.37%; specificity = 72.26). The instrument also showed a moderate correlation with the variables related to smartphone use (time spent on smartphones, number of messages sent and received, and number of times the smartphone is checked). These data indicate that the SAS-SV may be a reliable instrument for use with Brazilian adolescents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective : The objective of this study was to evaluate the effects of application of different fluences and energies of laser in the 24-, 48-, and 72-h periods in fibroblasts originating from human skin (HFF-1). Methods : The cell used as a template for cell proliferation was HFF-1. For the photobiomodulation (PBM) application, a 660 nm laser with a power of 40 mW and energies of 0.84, 1.40, 5.88, and 6.72 J was used. Five experimental groups were studied: one control group (CG) with simulated PBM and four groups that received PBM in different doses. The changes observed after laser irradiation were evaluated by cell viability (trypan blue) and proliferation [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)] tests. Intergroup comparisons were performed using two-way analysis of variance and the Tukey post hoc test (software GraphPad Prism 7.0). Results : In the trypan blue test, the total number of cells was significantly different between the irradiated groups and the CG at all times studied. The total number of cells increased in laser group (LG)1 (0.84 J) and LG2 (1.40 J) and decreased in LG4 (6.72 J). The mitochondrial activity increased significantly in LG1 and LG2 at 48 and 72 h and decreased in LG3 (5.88 J) and LG4 (6.72 J) compared with CG. Conclusions : The results indicate that the lower doses (0.45 and 0.75 J/cm 2 ) of PBM induce the highest mitochondrial activity and cellular viability.

One of the most promising strategies to improve the biological performance of bone grafts is the combination of different biomaterials. In this context, the aim of this study was to evaluate the effects of the incorporation of marine spongin (SPG) into Hydroxyapatite (HA) for bone tissue engineering proposals. The hypothesis of the current study is that SPG into HA would improve the biocompatibility of material and would have a positive stimulus into bone formation. Thus, HA and HA/SPG materials were produced and scanning electron microscopy (SEM) analysis was performed to characterize the samples. Also, in order to evaluate the in vivo tissue response, samples were implanted into a tibial bone defect in rats. Histopathological, immunohistochemistry, and biomechanical analyses were performed after 2 and 6 weeks of implantation to investigate the effects of the material on bone repair. The histological analysis demonstrated that composite presented an accelerated material degradation and enhanced newly bone formation. Additionally, histomorphometry analysis showed higher values of %BV/TV and N.Ob/T.Ar for HA/SPG. Runx-2 immunolabeling was higher for the composite group and no difference was found for VEGF. Moreover, the biomechanical analysis demonstrated similar values for all groups. These results indicated the potential of SPG to be used as an additive to HA to improve the biological performance for bone regeneration applications. However, further long-term studies should be carried out to provide additional information regarding the material degradation and bone regeneration.

Due to the complexity involved in the healing process of full thickness burns, the literature looks for alternatives to optimize tissue reconstruction. The objective of this study was to explore the action of photobiomodulation therapy associated with MSCs in the healing process of third degree burns. A total of 96 male Wistar rats were used, distributed in four groups with 24 animals each: Control Group, Laser Group, Cell Therapy Group, and Laser Group and Cell Therapy. The burn was performed with aluminum plate (150 °C). We performed analysis of wound contraction, histology, immunohistochemistry, birefringence analysis, and immunoenzymatic assay to evaluate tissue quality. Our results demonstrate that the association of the techniques is able to accelerate the repair process, modulating the inflammatory process, presenting a cutaneous tissue with better quality. Thus, we conclude that the use of photobiomodulation therapy associated with cell therapy is a promising treatment in the repair of total thickness burns., (© 2020 John Wiley & Sons, Ltd.)

Introduction: Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined., Materials and Methods: This a 4-arm randomized placebo-controlled trial with patient and evaluator blinded. This study will be performed in Department of Physical Therapy at Federal University of São Carlos, São Carlos/SP, Brazil. One hundred and forty-four patients with chronic neck pain will be randomized into 4 groups: active photobiomodulation therapy with active electrical stimulation, active photobiomodulation therapy, active electrical stimulation, or placebo treatment. They will receive 10 sessions of treatment., Primary Outcome: pain intensity (measured by pain numerical rating scale) posttreatment., Secondary Outcomes: pain during movement, neck disability, range of motion, pressure pain threshold, temporal summation, conditioned pain modulation, depressive symptoms, pain catastrophizing, quality of life, analgesic intake, and global perceived effect at posttreatment (10 sessions). Pain intensity and global perceived effect will also be measured after 6 weeks randomization., Discussion: The findings of this study might clarify the importance of using the photobiomodulation therapy and transcutaneous electrical nerve stimulation for patients with chronic neck pain., Trial Registration: NCT04020861. https://clinicaltrials.gov/ct2/show/NCT04020861?term=NCT04020861&draw=2&rank=1.

COVID-19, the disease caused by SARS-CoV-2 (novel coronavirus), emerged in China in December 2019 and spread quickly throughout the world. In this scenario, the current study aimed to identify the impact or effects of the COVID-19 pandemic on adolescents' health. This is a scoping literature review based on the following databases: Web of Science, CINAHL, PsycINFO, SciELO, and PUBCOVID19. The study adopted the stages proposed by the Joanna Briggs Institute for scoping reviews, and the question orienting the procedures consisted of the acronym PCC (population; concept; context). Eleven articles were included in the review. Clinically, adolescents present the same COVID-19 symptoms as adults. The pandemic and the health measures taken to control transmission were found to be associated with mental health problems in adolescents. Specifically, adolescents have a negative experience with social distancing measures and closing of schools. These measures can also favor situations of violence or aggressive behaviors in the home environment. Healthcare services that treat the adolescent population had to reorient their practices, adopting a virtual model to replace face-to-face care, and even research projects involving adolescence had to be rethought. This scoping review addressed an emerging theme in relation to a population that has received little attention in studies on COVID-19. The results suggest that the pandemic can be considered a determinant that affects different dimensions of adolescents' lives.

Skin Flap is used in reconstructive plastic surgery. However, complications such as ischemia followed by local necrosis may occur, requiring a new surgical procedure. It is well known that photobiomodulation therapy (PBMT) is an effective technique for improving microcirculation and neoangiogenesis, which contributes positively to the blood supply in the pre and post surgical period. Thus, the objective of the present study was to investigate the effects of preemptive treatment with laser PBMT with different energies on the viability in skin flaps in rats. Sixty-three Wistar rats, male, were randomized into five groups: Control Group (CG) (n = 15): PBMT simulation; Preemptive group 1.1 J laser (GP1) (n = 15): preemptive laser PBMT with 1.1 J of energy per point; Preemptive group 4 J laser (GP4) (n = 15): preemptive PBMT with 4 J of energy per point; Laser group 11 J (G1) (n = 9): PBMT immediately after surgery with 1.1 J of energy per point; Laser group 4 J (G4) (n = 9): TFMB immediately after surgery with 4 J of energy per point. The CG, GP1 and GP4 groups started treatment 72 h prior to surgery and were subdivided into two experimental periods, one of them on the day of the flap and the other along with the other groups on the seventh postoperative day. Three days after the randomization, the animals underwent random skin flap surgery. PBMT was performed with a 660 nm laser at three points. In the first experimental period, a greater number of vessels were found, as well as mast cells in GP1 compared to the CG and greater expression of fibroblast growth factor and vascular endothelial growth factor in the GP1 and GP4 groups compared to the CG. In the second experimental period, GP1 presented a lower percentage of necrotic tissue, a higher number of vessels and a percentage of cells labeled with both VEGF and hypoxia indicible factor alpha (HIF-1α) compared to the CG, FGF in GP1, GP4 and G4 when compared to the CG. Thus, it was concluded that preemptive treatment with PBMT with the application of 1.1 J of energy per point is effective in improving the viability of the skin flap., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The present study aimed to evaluate the effects of mesenchymal stromal cell (MSC) transplantation on motor function and collagen organization in the muscles of rats with type 1 diabetes mellitus. Male Wistar rats were randomly assigned to three groups: control (C), diabetic (DM) and diabetic treated with MSCs (DM-MSCs). Diabetes was induced by streptozotocin (50 µg/kg). Bone marrow cells were isolated from the tibia and femur. After 10 weeks of DM induction, the DM-MSC rats received four i.p. injections of MSCs (1 × 106). Ten weeks after MSC transplantation, motor performance was evaluated by the rotarod test and the anterior tibial (TA) muscles were collected for morphometric and quantification of collagen birefringence by polarizing microscopy analysis. Motor performance of the DM group was significantly reduced when compared to the C group and increased significantly in the DM + MSC group. The TA muscle mass was significantly reduced in the DM and DM + MSC groups compared to the C group. The connective tissue increased in the DM group compared to the C group and decreased in the DM + MSC group. The percentage collagen birefringence decreased significantly in the DM group when compared to the C group and increased in the DM + MSC group. Motor performance was positively correlated with collagen birefringence and negatively correlated with percentage of connective tissue. The results indicate that MSC transplantation improves both motor function and the collagen macromolecular organization in type 1 DM., (© 2020 The Authors. International Journal of Experimental Pathology © 2020 International Journal of Experimental Pathology.)

The use of mesenchymal stem cells (MSCs) in tissue engineering has been extensively investigated. The greater the proliferation of this cellular group, the greater the regenerative and healing capacity of the tissue to which they belong. In this context, photobiomodulation (PBM) is an efficient technique in proliferation of distinct cell types. However, its parameters and mode of action are still unclear and require further investigation. This study aimed to evaluate the PBM action with different energies in MSCs of adipose tissue (hASCs). We used hASCs, seeded in 24-well plates, with 3 × 10 4 cells per well, in culture media. We used a total of four experimental groups, one with hASCs and simulated PBM and three other groups, which received PBM irradiation at 24, 48, and 72 h, with a 660-nm laser and power of 40 mW and energy of 0.56, 1.96, and 5.04 J. We performed analyses of MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor) and trypan blue to evaluate cell proliferation and viability, 1 h after PBM irradiation. Software Graph PadPrism 7.0 was used. Intergroup comparisons were performed with ANOVA two-way and we used the Tukey post hoc test. Mitochondrial activity evaluated by MTT revealed the statistical difference in the first 24 h for group with more high energy when compared to control group; and in the 72 h for two irradiated groups when compared to the control group. The trypan blue test showed significant differences at the end of the experiment for two irradiated groups LG1 (4.52 × 10 4  ± 0.2) and LG2 (4.85 × 104 ± 0.8), when compared to the control group (1.87 × 10 4  ± 0.7). Both tests failed to be statistically different at the end of the experiment for groups LG1 and LG2 and observed a reduction in cellular mitochondrial growth and activity for group LG3. We conclude that PBM with energy close to 0.56 and 1.96 J promote proliferation of hASCs, and higher energy, such as 5.04 J, can be harmful.

Background: Web-based personalized normative feedback (PNF) interventions are less effective than their laboratory versions. Participant motivation may account for this reduced effect, but there is only a limited amount of research into the influence of motivation on PNF effectiveness. We evaluated the effectiveness of a web-based PNF in reducing alcohol use and consequences among college students with different motivation levels., Methods: Pragmatic randomized controlled trial among Brazilian college drinkers aged 18-30 years (N = 4460). Participants were randomized to a Control or PNF group and followed-up after one (T1), three (T2) and six (T3) months. Outcomes were: AUDIT score (primary outcome), the number of consequences, and the typical number of drinks. Motivation for receiving the intervention was assessed with a visual analog scale (range: 0-10). Generalized mixed models assessed intervention effects via two paradigms: observed cases and attrition models., Results: PNF reduced the number of typical drinks at T1 (OR = 0.71, p = 0.002), T2 (OR = 0.60, p < 0.001) and T3 (OR = 0.68, p = 0.016), compared to the control. Motivated students (score ≥3) receiving PNF also reduced the number of typical drinks at T1 (OR = 0.60, p < 0.001), T2 (OR = 0.55, p < 0.001) and T3 (OR = 0.56, p = 0.001), compared to the control. However, the attrition models were more robust at T1 and T2. In contrast, low-motivated students receiving the PNF increased AUDIT score at T3 (b = 1.49, p < 0.001)., Conclusions: The intervention reduced alcohol use, and motivation for receiving the intervention moderated the intervention effects. Motivated students reduced their typical alcohol use, whereas low-motivated students increased their AUDIT score., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Wound healing is a complex biological process with specific phases. Photobiomodulation (PBM) decreases the inflammatory infiltrate, stimulating fibroblast proliferation and angiogenesis, and therefore, is indicated for wound healing. Vitamin A is used to reverse the inhibitory effects on wound healing and accelerate the healthy granulation tissue. The study aimed to evaluate the effect of topical vitamin A and PBM (GaAlAs) in inflammatory phase of cutaneous wounds. Forty Wistar male rats were separated into four groups: (1) control (CG); (2) laser group (LG) GaAlAs, 670 nm, 30 mW, energy per point of 0.9 J, radiating by 1 point in 30 s; (3) vitamin A group (VitAG); and (4) laser group plus vitamin A (LG + VitAG). Wounds were surgically made by a punch biopsy with 10 mm of diameter on the back of the animals and all treatments were started according to the experiment. The treatments were administered for four consecutive days and biopsy was performed on day 4. We performed both H&E and immunohistochemistry analysis. The results were compared between groups by one-way analysis of variance ANOVA test with post hoc Tukey (p < 0.05). Inflammatory infiltrate increased significantly in LG compared to CG and VitAG (p < 0.05). Regarding angiogenesis, VEGF expression was increased significantly in LG and LG + VitAG groups, p < 0.01. The results indicate that proposed treatments were effective on the healing process improved by LG and LG + VitAG. We show that laser plus vitamin A enhances healing by reducing the wound area and may have potential application for clinical management of cutaneous wounds.

Bone defects following trauma represent a high impact on the quality of life of millions of people around the world. The aim of this study was to review photobiomodulation (PBM) action in the treatment of bone critical defects in rat calvaria, related to evaluation of the current protocols applied. One hundred and forty-seven articles related to the subject were found by searching the main databases (Pubmed, Lilacs, Web of Science, and Scopus) considering the period of publication until the year 2017, and only 14 corresponded the inclusion criteria established for this systematic review. The main parameters of the PBM were expressed in Table 1. In addition, it was possible to observe the use of two different wavelengths (red and infrared), which are considered therapeutic. Most of the evaluated articles presented positive results that describe a greater amount of neoformed bone, an increase in collagen synthesis, and a contribution to microvascular reestablishment. However, two studies report no effect on the repair process when the PBM was used. In addition, we observed considerable variations between the values of power, fluence, and total energy, which make it difficult to compare the results presented between the selected studies. It was possible to conclude that the infrared laser was more effective in positively stimulating the bone repair process of critical defects. Furthermore, a discrepancy was found in the parameter values used, which made it difficult to choose the best protocol for the treatment of this type of lesion.

Burn is defined as a traumatic injury of thermal origin, which affects the organic tissue. Low-level laser therapy (LLLT) has gained great prominence as a treatment in this type of injury; however, the application parameters are still controversial in the literature. The aims of this study were to review the literature studies that use LLLT as a treatment in burns conducted in an experimental model, discuss the main parameters used, and highlight the benefits found in order to choose an appropriate therapeutic window to be applied in this type of injury. The selection of the studies related to the theme was carried out in the main databases (PubMed, Cochrane Library, LILACS, Web of Science, and Scopus in the period from 2001 to 2017). Subsequently, the articles were then chosen that fell within the inclusion criteria previously established. In the end, 22 were evaluated, and the main parameters were presented. The analyzed studies presented both LLLT use in continuous and pulsed mode. Differences between the parameters used (power, fluence, and total energy) were observed. In addition, the protocols are distinct as to the type of injury and the number of treatment sessions. Among the results obtained by the authors are the improvements in the local microcirculation and cellular proliferation; however, a study reported no effects with LLLT as a treatment. LLLT is effective in accelerating the healing process. However, there is immense difficulty in establishing the most adequate protocol, due to the great discrepancy found in the applied dosimetry values.

Objective: To identify the main modalities of Internet-based interventions to limit alcohol use among university students, and to describe the effects of these interventions on alcohol use and related consequences., Methods: A systematic review of PubMed, PsycINFO, and SciELO was performed using as search terms "alcohol drinking AND Internet," without date or language restrictions. Inclusion criteria were randomized controlled trial design, focus on college students and on Internet-based interventions, and evaluating the effects of the intervention on alcohol use or alcohol-related consequences., Results: Thirty-six articles were analyzed. Two main intervention modalities were identified: personalized normative feedback (PNF, n=28) and multicomponent interventions (n=8). Twelve studies with PNF reported reductions in alcohol use 3 months after the intervention. Multicomponent interventions reduced alcohol use and related consequences; most studies focused on the website AlcoholEdu, which reduced alcohol consumption and the consequences of alcohol use 6 months after the intervention., Conclusions: FNP and the AlcoholEdu website, the most frequently evaluated interventions among the selected studies, were effective in reducing alcohol use in university students. These strategies are an alternative to increase the access of university students to interventions aimed at limiting alcohol use., Competing Interests: Conflitos de interesse. Nada declarado pelos autores.

Purpose: To present an alternative experimental model of third degree burn of easy reproducibility., Methods: Eighteen male Wister rats were randomly divided into three groups, 6 of which were allocated to each group. A soldering iron coupled to an aluminum plate was used to produce burn, at a temperature of 150ºC, with different exposure times per group. Group 5 (G5) animals were burned at 150°C with exposure time of 5 seconds; Group 10 (G10) the animals were burned at 150°C with exposure time of 10 seconds and group 15 (G15) the animals were burned at 150°C with exposure time of 15 seconds., Results: Histopathological analyzes showed that all three groups had similar morphological characteristics, with total thickness involvement., Conclusion: The technique is effective to reproduce a third degree burn and suggests the temperature of 150ºC with 5 seconds of exposure in order to minimize the risks to the animals.

Objective:: to evaluate problems associated with alcohol use among university students who reported binge drinking in comparison to students who consumed alcohol without binging., Method:: a cross-sectional study among university students (N=2,408) who accessed the website about alcohol use. Logistic and linear regression models were included in the statistical analyzes., Results:: alcohol use in the last three months was reported by 89.2% of university students; 51.6% reported binge drinking. Compared to students who did not binge drink, university students who presented this pattern were more likely to report all evaluated problems, among them: black out (aOR: 5.4); having academic problems (aOR: 3.4); acting impulsively and having regrets (aOR: 2.9); getting involved in fights (aOR: 2.6); drinking and driving (aOR: 2.6) and accepting a ride with someone who had drunk alcohol (aOR: 1.8). Students who binged also had higher scores on the Alcohol Use Disorders Identification Test (b=4.6; p<0.001), more negative consequences (b=1.0; p<0.001) and a reduced perception of the negativity of the consequences (b=-0.5; p<0.01)., Conclusion:: binge drinking was associated with an increase in the chances of manifesting problems related to alcohol use. The conclusions of this study cannot be generalized for all of the Brazilian population., Objetivo:: avaliar problemas associados ao uso de álcool entre universitários que relataram binge drinking em comparação a estudantes que consumiram álcool sem binge drinking., Método:: estudo transversal entre universitários (N=2.408) que acessaram website sobre o uso de álcool. Nas análises estatísticas incluíram-se modelos de regressão logística e linear., Resultados:: o uso de álcool, nos últimos três meses, foi relatado por 89,2% dos universitários e 51,6% referiram uso binge. Comparados a estudantes que não praticaram binge, universitários que apresentaram esse padrão tiveram maior chance de relatar todos os problemas avaliados, entre eles: incapacidade de lembrar o que aconteceu (aOR:5,4); problemas acadêmicos (aOR:3,4); agir impulsivamente e se arrepender (aOR:2,9); envolver-se em brigas (aOR:2,6); dirigir após beber (aOR:2,6) e pegar carona com alguém que bebeu (aOR:1,8). Estudantes que consumiram álcool no padrão binge também apresentaram maior pontuação no Alcohol Use Disorders Identification Test (b=4,6; p<0,001), mais consequências negativas (b=1,0; p<0,001) e menos percepção da negatividade das consequências (b=-0,5; p<0,01)., Conclusão:: a prática de binge drinking esteve associada ao aumento das chances de manifestação de problemas relacionados ao uso de álcool. As conclusões deste estudo não podem ser reproduzidas para toda realidade brasileira., Objetivo:: evaluar problemas asociados al uso de alcohol entre estudiantes universitarios que relataron binge drinking en comparación a estudiantes que consumieron alcohol sin binge drinking., Método:: estudio transversal entre estudiantes universitarios (N=2.408) que visitaron una página web sobre el uso de alcohol. En los análisis estadísticos, fueron incluidos modelos de regresión logística y linear., Resultados:: el uso de alcohol, en los últimos tres meses, fue relatado por 89,2% de los estudiantes universitarios, y entre ellos 51,6% relataron uso binge. En comparación a estudiantes universitarios que no practicaron binge, los estudiantes que presentaron ese estándar tuvieron una mayor oportunidad de relatar todos los problemas evaluados, entre ellos: incapacidad de recordar lo que sucedió (aOR:5,4); problemas académicos (aOR:3,4); actuar por impulso y arrepentirse (aOR:2,9); involucrarse en peleas (aOR:2,6); manejar después de beber (aOR:2,6) y compartieron viaje con alguien que bebió (aOR:1,8). Estudiantes que consumieron alcohol dentro del estándar binge también presentaron una mayor puntuación en el Alcohol Use Disorders Identification Test (b=4,6; p<0,001), más consecuencias negativas (b=1,0; p<0,001) y menor percepción de la negatividad de las consecuencias (b=-0,5; p<0,01)., Conclusión:: la práctica de binge drinking estuvo asociada al aumento de las oportunidades de manifestación de problemas relacionados al alcohol. Las conclusiones de este estudio no pueden ser adaptadas a toda la realidad brasileña.

Neuropathic pain can be defined as the pain initiated or caused by a primary lesion or dysfunction of the central or peripheral nervous system. Photobiomodulation therapy (PBM) stands out among the physical therapy resources used for analgesia. However, application parameters, especially the energy density, remain controversial in the literature. Therefore, this study aimed to investigate the PBM effect, in different energy densities to control neuropathic pain in mice. Fifty (50) mice were induced to neuropathy by chronic constriction surgery of the sciatic nerve (CCI), treated with PBM (808 nm), and divided into five groups: GP (PBM simulation), GS (sham), GL10, GL20, GL40 (energy density of 10, 20, and 40 J/cm 2 , respectively). The evaluations were carried out using the hot plate test and Randall and Selitto test, before and after the CCI surgery, every 15 days during the 90 days experiment. β-Endorphin blood dosage was also tested. For both the hot plate and Randall and Selitto tests, the GL20 and GL40 groups presented reduction of the nociceptive threshold from the 30th day of treatment, the GL10 group only after day 75, and the GP group did not show any improvement throughout the experiment. The β-endorphin dosage was higher for all groups when compared to the GP group. However, only the GL20 group and GL40 presented a significant increase. This study demonstrates that PBM in higher energy density (20, 40 J/cm 2 ) is more effective in the control of neuropathic pain.