GEORGE MIGUEL GOES FREIRE

Índice h a partir de 2011
2
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico

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  • conferenceObject
    EFFICACY OF PHOTOBIOMODULATION IN RELIEVING POSTOPERATIVE PAIN IN PATIENTS WITH KNEE OSTEOARTHRITIS UNDERGOING TOTAL KNEE REPLACEMENT
    (2021) REZENDE, M. U. De; FREIRE, G. M.; VARONE, B. B.; MARTUSCELLI, D. F.; OCAMPOS, G. P.; PINTO, N. C.; SOUSA, M. V. De; ASHMAWI, H. A.; CAMARGO, O. P. De
  • article
    Peripheral and central sensitization
    (2016) ASHMAWI, Hazem Adel; FREIRE, George Miguel Góes
    ABSTRACT BACKGROUND AND OBJECTIVES: Central sensitization is an important phenomenon for pain chronicity and is present in neuropathic pain. This study aimed at addressing some pathophysiological aspects of this phenomenon. CONTENTS: Some extra and intracellular aspects responsible for central sensitization genesis, especially phenotypic changes in plasticity of neurons involved in the process are described. CONCLUSION: Pain chronicity may result from changes in central nervous system neurons properties by the central sensitization phenomenon with constant changes in membrane excitability, inhibitory transmission reduction and increase in synaptic efficacy mediated by several convergent and divergent molecular mechanisms over a background of phenotypic and structural changes. Neuroplasticity deeply alters painful sensation, contributing for many clinical painful syndromes and may represent a major target for therapeutic intervention.
  • article
    Dor crônica refratária de tornozelo controlada com radiofrequência pulsada: relato de caso
    (2012) PELLOSO, Lia Rachel Chaves do Amaral; FREIRE, George Miguel Góes; ASHMAWI, Hazem Adel
    BACKGROUND AND OBJECTIVES: Radiofrequency (RF) is an alternate current with oscillation frequency of 500,000 Hz, which has been successfully used to treat some morbidities evolving with chronic pain. This case report aimed at showing the successful use of sural nerve pulsed RF to treat chronic ankle pain. CASE REPORT: Female patient, 60 years old, with right ankle pain for five years, refractory to treatment with opioids, non-steroid anti-inflammatory drugs (NSAIDs), dipirone, antidepressants and anticonvulsants, physical therapy, localized infiltrations, acupuncture and insole. Patient was submitted to right sural nerve pulsed RF. Needle was inserted in the line between the Achilles tendon and lateral malleolus, initial Achilles tendon region and final soleus and gastrocnemius muscles region. Sensory stimulation to identify the sural nerve was with 0.5 volts and 50 Hz. Pulsed current was applied for 140 seconds with 45 volts and temperature of up to 42º C. Patient was submitted to two sessions with improvement of approximately 80% of pain, allowing her to walk or to remain standing up without major difficulties. CONCLUSION: Sural nerve pulsed RF may be an option to control chronic ankle pain.
  • article 2 Citação(ões) na Scopus
    Customized Photobiomodulation Modulates Pain and Alters Thermography Pattern in Patients with Knee Osteoarthritis: A Randomized Double-Blind Pilot Study
    (2022) PINTO, Nathali Cordeiro; SOUSA, Marcelo Victor Pires de; FERREIRA, Nathalia Lopes; BRAGA, Natalia Almeida; ALDRED, Alexandre; GOMES, Guilherme; FREIRE, George Miguel Goes; ASHMAWI, Hazem Adel; CHACUR, Marucia
    Background: Photobiomodulation therapy (PBMT) modulates a wide variety of biological processes, leading to anti-inflammatory and analgesic effects. Understanding the mechanisms underlying therapeutic effects of PBMT remains challenging due to varying outcomes observed between wavelengths, dosage, and site of application. Our research group has dedicated close attention to customization and individualization of dosimetry for PBMT protocols. Preliminary data showed that using an individualized treatment could solve contradictory results reported by previous studies. Based on literature and our preliminary data on light absorption, the goal of the present pilot is to determine whether our individualized dosimetry is a feasible method to assist osteoarthritis (OA) pain control. Methods: This parallel two-arm controlled-pilot study aimed to assess whether personalized PBMT can be effective in the treatment of painful chronic knee OA. Thirty-one patients were randomly allocated into treatment and placebo group (sham irradiation), and the treatment procedure was performed twice a week, for 5 weeks. The PBMT was applied using 850nm with continuous wave and a total of 526-1402J each session. Individualized dosimetry was chosen based on each patient's body mass index and skin color. Quality-of-life (QOL) questionnaires and serum/urine analyses were performed before and after treatment was over. Both examiners and participants were blinded to group allocation. Results: Pain scores were reduced significantly in the 4th, 5th, and 10th sessions and remained lower 6 weeks posttherapy in the treatment group when compared to the placebo group. Moreover, the treatment group's results were improved in QOL questionnaires score, dopamine level, and in microcirculation. Conclusions: The present results provide initial evidence that customized photobiomodulation (PBM) reduce pain levels in short- and medium-term in patients with symptomatic knee OA when compared to placebo group. Furthermore, we have provided evidence that customized PBM is able to improve the QOL of those patients.
  • bookPart
    Protocolo de analgesia para pacientes politraumatizados
    (2014) FERREIRA, Flávio Silva; FREIRE, George Miguel Góes; ASHMAWI, Hazem Adel; SOUSA, Katiane Régia Oliveira de; AWADE, Roberto
  • bookPart
    Tratamento da Dor no Paciente com Câncer
    (2017) SOUSA, Angela Maria; SLULLITEL, Alexandre; TAHAMTANI, Sílvia Maria Machado; FREIRE, George Miguel Góes; ESPADA, Eloisa Bonetti
  • bookPart
    Tratamento da Dor no Paciente com Câncer
    (2021) SOUSA, Angela Maria; SLULLITEL, Alexandre; TAHAMTANI, Sílvia Maria Machado; FREIRE, George Miguel Góes; ESPADA, Eloisa Bonetti
  • conferenceObject
    PHOTOBIOMODULATION: A NEW TOOL FOR POSTOPERATIVE PAIN IN TOTAL KNEE ARTHROPLASTY? A CASE SERIES
    (2021) OCAMPOS, G.; AROUCA, M.; REZENDE, M.; VARONE, B.; MARTUSCELLI, D.; FREIRE, G.; PINTO, N.; SOUZA, M.; CAMARGO, O.
  • bookPart
    Tratamento de dor da coluna vertebral
    (2020) ROCHA, Roberto de Oliveira; FREIRE, George Miguel Góes; BERGAMASCHI, Esthael Cristina Querido Avelar
  • article 4 Citação(ões) na Scopus
    Pilot study of the effect of therapeutic photobiomodulation on postoperative pain in knee arthroplasty
    (2022) REZENDE, Marcia Uchoa de; VARONE, Bruno Butturi; MARTUSCELLI, Diego Ferreira; OCAMPOS, Guilherme Pereira; FREIRE, George Miguel Goes; PINTO, Nathali Cordeiro; SOUSA, Marcelo Victor Pires de
    Abstract Nine participants undergoing primary TKA submitted to spinal anesthesia, sedation, ultrasound-guided obturator and Femoral nerve Block analgesia, and photobiomodulation Therapy (FBMT) were evaluated regarding postoperative pain and morphine consumption. FBMT sessions were performed in the Immediate Postoperative period (IPO) and after 24 hours. Participants received 16.7±15 mg of morphine up to the third postoperative day. At IPO, mean pain score was 4.8 ± 3.2 and 5.6 ± 3.5, at rest and on movement, respectively. Photo biomodulation therapy can be considered an option for mitigating pain for patients undergoing TKA.