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Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p90-93
Pan Am J Med Thermol 2(2): 90-93 90
Resumo - O exame termográfico tem sido
aplicado em quase todos os ramos da medicina.
Portanto, esse trabalho tem por objetivo
demonstrar por termografia, os efeitos térmicos
da ozonioterapia, em um paciente com quadro de
epicondilite lateral direita, com seis meses de
duração. Paciente, 53 anos, masculino,
apresentou-se com quadro de epicondilite lateral,
à direita, há 6 meses, com dor intensa na região
proximal do antebraço, estendendo-se pelos
tendões extensores até o punho, com limitação
dos movimentos de extensão e rotação do
antebraço. Após uma assepsia com álcool,
aguardou-se que a temperatura local retornasse
ao normal, e realizou-se a infiltração de 10 ml da
mistura de O2/O3 a uma concentração de 18
mcg/ml. O exame de termografia se mostrou
eficaz na detecção das alterações de temperatura
no local da inflamação, no entanto, mais
trabalhos com injeção da mistura de O2/O3 em
patologias semelhantes são necessários, para
determinar se o comportamento térmico foi uma
resposta direta da aplicação da mistura O2/O3 ou
devido ao quadro álgico do paciente que
determinou os padrões térmicos expostos nessa
pesquisa.
Palavras-chave: Termografia; ozonioterapia;
epicondilite lateral, dor de cotovelo de tênis.
Abstract - The thermographic exam has been
applied in almost all branches of medicine.
Therefore, this paper aims to demonstrate, by
thermography, thermal effects of ozone therapy
in a patient with a right lateral epicondylitis
frame of six months of duration. Patient, 53,
male, presented himself with right lateral
epicondylitis, for 6 months, with intense pain in
the proximal region of the forearm, extending
from the extensor tendons to the hilt, with
limitation of forearm extension and rotation
movements. After sterilization with alcohol, was
waited that the local temperature returned to
normal, and an infiltration of a mixture of 10 ml
of O2 / O3 at a concentration of 18 mcg / ml was
done. The thermographic exam was proven
effective in detecting temperature changes at the
site of inflammation, however, more work with
injection of the mixture of O2 / O3 in similar
conditions are required to determine if the
thermal behavior is a direct response application
of mix O2 / O3 or if it was caused by the painful
condition of the patient who determined the
thermal patterns exposed in this research.
Keywords: Thermography, ozonetherapy, lateral
Epicondylitis, tennis elbow pain.
Uso da Termografia na Avaliação da Ozonioterapia como Tratamento da
Epicondilite Lateral
Celso Felício de Carvalho1, Marcos Leal Brioschi1,2 , Manoel Jacobsen Teixeira1,3
1. Pos-graduação em Termologia e Termografia da Faculdade de Medicina (USP)
2. Associação Brasileira de Termologia (ABRATERM)
3. Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo (USP)
E-mail: homeopatiar@uol.com.br
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p90-93
Pan Am J Med Thermol 2(2): 90-93 91
1. INTRODUÇÃO
O termo termografia infravermelha significa a
gravação da temperatura ou a distribuição da
temperatura do corpo pela radiação emitida pela
superfície do corpo. (1,2) Os raios
infravermelhos são parte de um espectro
eletromagnético invisível, acima dos raios
visíveis e próximo das micro-ondas (3-5).
Possuem características físicas similares a todas
os comprimentos de ondas visíveis e outras
ondas, mas diferem delas por transportar grandes
quantidades de energia térmica, quando emitidas
ou absorvidas. (3, 2, 6) Essa propriedade é básica
para o entendimento dos princípios desse
moderno equipamento de imagem para detecção
da irradiação infravermelha. A temperatura da
pele, sob condições ambientais cuidadosamente
controladas, é influenciada principalmente pela
atividade microcirculatória desta e, pela produção
de calor conduzida para a superfície gerada em
tecidos mais profundos.
Atualmente, muitas patologias inflamatórias
vêm sendo tratadas com a Ozonioterapia. Em
utilização médica, o gás produzido a partir de
oxigénio de grau medicinal é administrado em
doses terapêuticas precisas, e nunca por via
inalatória. Apresenta benefícios de saúde
excelentes em cárie dentária, (12) na diminuição
do colesterol sanguíneo e estimulação de
respostas antioxidantes, (13) modifica a
oxigenação em repouso muscular(14) e também é
utilizado no tratamento complementar das
síndromes hipóxicas e isquêmicas, hérnias discais
e lesões osteomusculares (15). O efeito da
Ozonioterapia quando aplicado no local da lesão
inflamatória, muitas vezes é imediato. A
alteração de temperatura na região afetada, pode
ser um indicativo deste efeito e o exame de
termografia pode ser utilizado para comprovação
da eficácia.
Portanto, esse trabalho tem por objetivo
demonstrar por termografia, os efeitos térmicos
da ozonioterapia, em um paciente com quadro de
epicondilite lateral direita, com 6 meses de
duração.
2. RELATO DE CASO
Paciente, 53 anos, masculino, apresentou-se
com quadro de epicondilite lateral, à direita, há 6
meses, com dor intensa na região proximal do
antebraço, estendendo-se pelos tendões
extensores até o punho, com limitação dos
movimentos de extensão e rotação do antebraço.
O mesmo trouxe consigo um exame
ultrassonográfico da região acometida. O
tratamento de escolha foi a ozonioterapia.
O paciente foi orientado quanto à filmagem
termográfica. Foi posicionado confortavelmente
em uma poltrona reclinável, como braço apoiado
sobre uma almofada. Iniciou-se a termalização
por 10 minutos, numa sala climatizada em 21°C.
A filmagem se deu por uma Câmera Flir T 440,
posicionada perpendicularmente ao cotovelo
direito, há uma distância de 40 cm. Após uma
assepsia com álcool, aguardou-se que a
temperatura local retornasse ao normal, e
realizou-se a infiltração de 10 ml da mistura de
O2/O3 a uma concentração de 18 mcg/ml, no
ponto El1. Nesse instante iniciou-se a filmagem
durante 21 min. Foram selecionadas 3 áreas de
interesse termográfico. Uma na região do
epicôndilo direito (El1), outra terceira na porção
media do antebraço (Ar1) e outra na região distal
do braço direito (Ar2).
Na região selecionada, El1, que se apresenta
como a região de maior radiação termográfica foi
avaliada pela temperatura máxima, por ser uma
área pequena. As áreas Ar1 e Ar2, foram
avaliadas pela temperatura média por se tratar de
áreas de maior extensão.
3. RESULTADOS
Os resultados das imagens termográficas estão
descritos na Tabela 1 e a figura 1 ilustra os
resultados, onde é possível comparar a imagem
logo após a aplicação da mistura O2/O3 e após 21
minutos.
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p90-93
Pan Am J Med Thermol 2(2): 90-93 92
Tabela 1. Comportamento térmico das áreas selecionadas após infiltração do ozônio.
MINUTOS
El1
(°C)
Ar2
(°C)
0
32,5
29,9
1
32,5
29,7
2
31,7
29,7
3
31,8
29,6
4
32,1
29,7
5
32,4
29,7
8
32,4
29,6
9
32,5
29,4
10
32,7
29,5
10
32,8
29,3
12
32,7
29,5
13
32,9
28,9
14
33,1
28,9
15
33,2
29
16
33,2
28,9
17
33
28,7
18
33,1
28,7
19
32,9
28,4
20
33,1
28,4
21
32,9
28,2
∆ °C
+0,4
-1,7
Imagem colhida logo após a aplicação da mistura
O2/O3
Imagem colhida 21 minutos após a aplicação da
mistura O2/O3
Figura 1. Imagens inicial e final do sujeito durante aplicação da mistura O2/O3.
O ponto El1, no terceiro minuto apresentou
uma queda na temperatura de 0.8°C. Aos 14
minutos observou-se o pico de maior
temperatura, 33.2°C, que se manteve até o 15º
minuto, quando então iniciou uma queda
terminando no 21º minuto com 32.68°C,
resultando num ∆ de +0.4.
A área Ar1, correspondente à porção média do
antebraço direito, no primeiro minuto apresentou
uma temperatura de 31,1°C e, logo após a
aplicação, apresentou uma queda, que atingiu seu
mínimo no 20º minuto, 28,7°C, passando então a
aquecer chegando ao 21º minuto em 29,765 °C,
resultando num ∆ de -2.4°C.
A área Ar2, correspondente à porção distal do
braço direito, no primeiro minuto apresentou uma
temperatura de, 29.9°C , quando iniciou uma
queda, atingindo seu mínimo no 20º minuto,
28.2°C, passando então a aquecer, chegando ao
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p90-93
Pan Am J Med Thermol 2(2): 90-93 93
21º minuto em 29.185°C, resultando num ∆ de -
1.7°C.
4. DISCUSSÃO
A presente investigação teve por finalidade
avaliar alterações térmicas na região do
epicôndilo lateral direito, na região intermédia do
antebraço direito e, região distal do braço direito,
após a aplicação da mistura O2/O3, por imagens
captadas com teletermografia infra-vermelha.
A brusca queda da temperatura logo após a
aplicação do ozônio pode ter sido causada por
uma ação direta do ozônio no sistema circulatório
local e regional ou, uma reação adrenérgica em
resposta à dor sentida pelo paciente, pois,
avaliado por uma (EVN), escala visual numérica
de dor, de 0 a 10, o paciente referiu uma dor de
intensidade (9).
A aplicação de ozônio, demonstrou aumento
na temperatura na região do epicôndilo lateral
conseqüência a uma vasodilatação dessa região
e, uma queda de temperatura nas região distal do
braço direito e da porção intermédia do antebraço
direito, por causa de uma vasoconstrição das
regiões referidas.
5. CONCLUSÃO
O exame de termografia se mostrou eficaz na
detecção das alterações de temperatura no local
da inflamação, no entanto, mais trabalhos com
injeção da mistura de O2/O3 em patologias
semelhantes são necessários, para determinar se o
comportamento térmico foi uma resposta direta
da aplicação da mistura O2/O3 ou devido ao
quadro álgico do paciente que determinou os
padrões térmicos expostos nessa pesquisa.
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... Gaseous ozone in relatively high concentrations (25 parts per million-ppm) has also been used to inactivate norovirus and bacteria in office and hotel rooms, removing this ozone after using a system purifier [51,52]. In medicine, O 3 has already been used in different forms of application (parenteral or local), aiming to combat ischemia, joint diseases, immunosuppression, degenerative diseases, and infections [72][73][74], and for therapeutic purposes [75,76]. However, in high concentrations, it becomes toxic [77]. ...
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USP) E-mail: homeopatiar@uol.com.br 11. Geoffroy P., Yaff M., Rohan I. Diagnosing and treating lateral epicondylitis
Departamento de Neurologia da Faculdade de Medicina da Universidade de São Paulo (USP) E-mail: homeopatiar@uol.com.br 11. Geoffroy P., Yaff M., Rohan I. Diagnosing and treating lateral epicondylitis. Can Fam Physician. 1994;40:73–78.
  • F Hernandez
  • S Menéndez
  • R Wong
Hernandez F, Menéndez S, Wong R. Free Radic Biol Med. 1995 Jul; 19(1):115-9.