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

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 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.

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. The internal carotid artery does not emit cervical branches and penetrates the skull through the carotid canal. The posterior part of the brain is irrigated by the vertebral artery (branch of the subclavian artery). The external carotid artery is related to muscles and nerves -sternocleidomastoid, digastric, hyoid-style, hypoglossal nerve, submandibular gland and angle of the mandible [1].
The main branches of the external carotid artery are: Upper thyroid artery: thyroid gland and larynx; Lingual artery: muscles of the tongue, floor of the mouth, sublingual gland; Facial artery suprahyoid muscles, lower and upper lip;   Dysgeusia is variably defined as an abnormality harmful to taste sensations, which causes unpleasant alteration of the taste sensation, or a distortion or perversion of the sense of taste. It can be described as bitter, metallic, salty or unpleasant taste. Dysgeusia is closely linked to changes in taste. Flavors provide sensory information related to sensory pleasure and these sensory functions are directly affected by cancer therapies [6]. These changes in taste in patients with cancer are prevalent problems due to the malignancy itself or to the therapeutic interventions that affect the daily quality of life of these patients and may lead to malnutrition, weight loss and, in severe cases, significant morbidity [7,8]. This sensory system in cancer patients is orchestrated by numerous exogenous and endogenous factors that interact with one another. Faced with this, these factors are responsible for abnor-

Am J Biomed Sci & Res
Copyright@ Juliano Abreu Pacheco 274 malities of taste and odor due to this interconnection. However, such damage to sensory receptor cells is abnormal, but the etiology of these is related to the neuronal activities causing taste and odor abnormalities in these patients. And according to contemporary scientific research, these disorders are probably multifactorial.
But it is conclusive by many authors that oncological therapies can cause taste disturbance with the destruction of taste receptors.
And this cellular damage may manifest in three ways: It is important to note that since the 1980s there has been a dramatic increase in the number of research involving infection and cancer. The results of such research have made cancer today eminently regarded as a host disease and environmental factors, which together are capable of altering various aspects of cellular metabolism by making the affected cells more competitive in terms of rate of replication, reduction of apoptosis, resistance to therapies, and with greater invasiveness and colonization. However, several articles have shown that infectious agents should play a central role in about 20% of neoplasias [11,12], which is based on types of cancer with known infectious etiology such as cervical, hepatic and gastric cancer [11]. There are sites in the human body, including the entire aerodigestive tract, where the contact with the external environment is greater, making the direct role that the microbiome has on these more prominent sites. Among these body regions, the intestine and the "oral cavity" have the highest and second highest microbial diversity, suggesting that the study of the relationship between these microorganisms and other regions of the body may contribute to the greater knowledge about their relationship caus-al or not) with the development of diseases caused by infectious agents, including cancer [13]. The installation of dysgeusia in the oral cavity allows the patient a physiological decrease in the immune system, which corrupts the rest of the stomatognathic system, through the potentiation of the microbioma that plays a key role in metabolism, inflammation and immunity. contribute to carcinogenesis. To date, there are some hypotheses for bacterial-mediated carcinogenesis mechanisms, such as the activation of Toll-like receptors, bacterially derived genotoxins, bacterial virulence factors, and carcinogenesis affected by microbial metabolism [14]. While the microorganisms present in the various mucous membranes of the body can become part of the tumor microenvironment, other microorganisms can invade the cells, becoming intratumoral, resulting in tumor growth through different pathways [15].
Alternatively, the "oral microbiome" initiates the breakdown of dietary elements and produces pro-carcinogenic agents [16].
In a recent analysis of microorganisms found in the mucosa oral healthy, a large number of microorganisms capable of producing high amounts of acetaldehyde from ethanol [16] have been demonstrated, a fact of concern regarding the carcinogenic properties of acetaldehyde, as well as the positive association between alcohol and certain types of cancer.
Thus, it is now recognized that the microbiota contributes to carcinogenesis in three broad ways: a.
Altering the balance between death and proliferation of host cells; b. acting on the balance of the immune system; and c.
Influencing the metabolism of several substances, being able to generate pro -or anti -tumor substances [17].
Hence the importance of the balance of oral cavity functionalities for the stabilization or regression of carcinogenic conditions.  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. 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  (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 mat-uration, 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