Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PHOTOTHERAPY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2005

Post-phototherapy neonatal bilirubin rebound: a potential cause of significant hyperbilirubinaemia.

AIM: To determine the incidence of post-phototherapy neonatal plasma total bilirubin (PTB) rebound. METHODS: A prospective clinical survey was performed on 226 term and near-term neonates treated with phototherapy in the well baby nursery of the Shaare Zedek Medical Center from January 2001 to September 2002. Neonates were tested for PTB 24 hours (between 12 and 36 hours) after discontinuation of phototherapy, with additional testing as clinically indicated. The main outcome measure, significant bilirubin rebound, was defined as a post-phototherapy PTB > or =256 micromol/l. Phototherapy was not reinstituted in all cases of rebound, but rather according to clinical indications. RESULTS: A total of 30 (13.3%) neonates developed significant rebound (mean (SD) PTB 287 (27) micromol/l, upper range 351 micromol/l). Twenty two of these (73%) were retreated with phototherapy at mean PTB 296 (29) micromol/l. Multiple logistic regression analysis showed significant risk for aetiological risk factors including positive direct Coombs test (odds ratio 2.44, 95% CI 1.25 to 4.74) and gestational age <37 weeks (odds ratio 3.21, 95% CI 1.29 to 7.96). A greater number of neonates rebounded among those in whom phototherapy was commenced < or =72 hours (26/152, 17%) compared with >72 hours (4/74, 5.4%) (odds ratio 3.61, 95% CI 1.21 to 10.77). CONCLUSION: Post-phototherapy neonatal bilirubin rebound to clinically significant levels may occur, especially in cases of prematurity, direct Coombs test positivity, and those treated < or =72 hours. These risk factors should be taken into account when planning post-phototherapy follow up.

Bilirubin↗
PubMed2001

[Fiberoptic phototherapy of neonatal jaundice. Comments to a Cochrane report].

Twenty-four studies filled the inclusion criteria for a Cochrane report on the use of fiberoptic phototherapy for neonatal jaundice. Fiberoptic phototherapy lowers serum bilirubin and may have a place in the treatment of neonatal jaundice. In term and near-term infants fiberoptic phototherapy is inferior to conventional phototherapy, whereas in premature infants the effects are comparable. A better effect is achieved when conventional and fiberoptic phototherapy are combined as compared to conventional phototherapy alone. Fiberoptic phototherapy has not been shown to interfere less with parent-infant bonding than conventional phototherapy. There continues to be a great need for research concerning phototherapy for neonatal jaundice.

Evidence-Based Medicine↗
PubMed2002

[Fiberoptic phototherapy for neonatal icterus--comments to a Cochrane report].

Twenty-four studies filled the inclusion criteria for a Cochrane report on the use of fiberoptic phototherapy for neonatal jaundice. Fiberoptic phototherapy lowers serum bilirubin and may have a place in the treatment of neonatal jaundice. In term and near-term infants fiberoptic phototherapy is inferior to conventional phototherapy, whereas in premature infants the effects are comparable. A better effect is achieved when conventional and fiberoptic phototherapy are combined as compared to conventional phototherapy alone. Fiberoptic phototherapy has not been shown to interfere less with parent-infant bonding than conventional phototherapy. There is still a great need for more research on phototherapy for neonatal jaundice.

Evidence-Based Medicine↗
PubMedDate not supplied

Changing position does not improve the efficacy of conventional phototherapy.

The aim of this study was to compare the efficacy of position-changing phototherapy with conventional fixed-position phototherapy. Clinically well, term infants with nonhemolytic hyperbilirubinemia were enrolled in the study. After entry into the study, infants were randomly assigned to receive single-direction phototherapy with or without changing from a supine to a prone position or vice versa every 2 h. Phototherapy was initiated when the serum bilirubin concentration was greater than 15 mg/dl and was discontinued when the bilirubin level had declined below 10 mg/dl. Total serum bilirubin concentrations were measured just prior to initiation of phototherapy and at 12-h intervals until phototherapy was discontinued. The rate of bilirubin decline expressed by the first and secondary 24-h declines and overall bilirubin concentration decrease per hour were comparable between the two groups. The rebound in bilirubin levels after cessation of phototherapy was negligible, and none of the infants needed re-phototherapy. We conclude that changing an infant's position at 2-h intervals does not improve the efficacy of conventional single-direction phototherapy.

Breast Feeding↗
PubMed1976

Effects of phototherapy on platelet counts in low-birthweight infants and on platelet production and life span in rabbits.

The effects of conventional phototherapy on platelets in vivo were studied in rabbits and in low-birthweight infants. Rabbits were divided into three groups and individually treated continuously for 96 hours, with blue light, daylight, or no phototherapy. Incorporation of selenomethionine Se75 was used to evaluate platelet production and life span. Platelet turnover was significantly increased in the blue-light phototherapy group, and was also increased in the daylight group but to a lesser degree. Daily platelet counts and hematocrits were performed in infants weighing less than 2,000 gm at birth randomized at 24 +/- 12 hours of life to receive daylight phototherapy continuously for 96 hours (31 infants) or no phototherapy (26 infants). In 12 treated infants (38.7%) platelet counts fell below 150,000/cu mm whereas this occurred in only 3 (11.5%) of the controls. These two lower platelet count subgroups differed significantly in mean gestational age and birthweight with the phototherapy group being the more mature. Pre-phototherapy, the mean platelet count of these 12 infants was lower than the mean of the entire control group, suggesting that these infants had borderline marrow reserve before phototherapy was given. These results suggest that phototherapy increases the rate of platelet turnover. When bone marrow compensation is inadequate, the platelet count may fall.

Animals↗
PubMed2006

A randomised control trial of clingfilm for prevention of hypothermia in term infants during phototherapy.

INTRODUCTION: This study aimed to compare the core, abdominal wall, and plantar temperatures of well jaundiced term infants undergoing phototherapy with or without clingfilm covering the lower two-thirds of the upper end of their bassinets. METHODS: This was a randomised controlled trial carried out in a tertiary university hospital on normal healthy term infants undergoing phototherapy. 106 eligible infants were randomised to receive phototherapy with (n=52) or without (n=54) the use of clingfilm during a two-hour period. Subsequently, after nappy change and feeding, they were crossed over to receive phototherapy without or with the clingfilm in place, respectively. Their body temperatures were measured at zero and two hours after phototherapy. RESULTS: There was no significant difference in their core, abdominal wall and plantar temperatures at baseline and after two hours of phototherapy (p-value is greater than 0.05) between infants with and without the use of clingfilm. Irrespective of the use of clingfilm, there was significant (p-value is less than 0.001) increase in core body temperatures after two hours of continuous phototherapy, with resultant hyperthermia (greater than 37.5 degree Celsius) in 42 percent of infants when under clingfilm and 35.8 percent when without clingfilm. A few (2.8 percent) infants, though statistically not significant, became mildly hypothermic after two hours of phototherapy when clingfilm was not used (p-value is greater than 0.05). CONCLUSION: Hyperthermia was common during phototherapy, irrespective of the use of clingfilm. Hypothermia was rare and the preventive role of clingfilm is not certain.

Body Temperature↗
PubMed1998

Effect of UV-B phototherapy on plasma HIV type 1 RNA viral level: a self-controlled prospective study.

OBJECTIVE: To study the plasma human immunodeficiency virus type 1 (HIV-1) RNA levels of 12 patients seropositive for HIV who were undergoing UV-B phototherapy to determine if UV-B phototherapy upregulates HIV activity in humans. DESIGN: A self-controlled prospective cohort of HIV-infected patients seen for the treatment of a skin disorder responsive to UV-B phototherapy. Viral levels were measured weekly for 8 weeks of phototherapy. Follow-up viral levels were measured for patients who continued phototherapy beyond 8 weeks, those who had a significant change in their viral level, or both. SETTING: Outpatient clinic of an academic hospital. PATIENTS: Patients with HIV disease and a skin disorder responsive to UV-B phototherapy. Inclusion criteria for patients in this study were those receiving a stable antiviral regimen for at least 6 weeks and who had no major illness or immunization in the 2 months before starting phototherapy. Of 72 patient volunteers screened, 15 met the criteria, 2 declined to participate, and 13 entered the study. One patient was dropped from the study because an accurate baseline measurement could not be obtained. Twelve patients were analyzed, 2 of whom left the study early, 1 at 6 weeks and 1 at 7 weeks. INTERVENTIONS: Ultraviolet-B phototherapy. MAIN OUTCOME MEASURE: Plasma HIV-1 RNA viral level. RESULTS: Plasma HIV-1 RNA levels showed no significant increase or decrease in most of the patients, defined as a 3-fold change from baseline (mean fold change from baseline after 8 weeks of phototherapy, -1.1; 95% confidence interval, 2.9 to -5.0). Trend analysis indicated no significant pattern of change in viral levels (slope, -0.013 log; P > .25). The CD4+ cell counts also remained unchanged (mean before therapy, 277 x 10(9)/L; mean after therapy, 285 x 10(9)/L; P = .67). CONCLUSION: No significant effect of UV-B exposure was seen on plasma HIV-1 levels.

Adult↗
PubMed2006

Time course of tanning induced by narrow-band UVB phototherapy in Korean psoriasis patients.

BACKGROUND: Narrow-band (TL-01) UVB lamps are being increasingly used for phototherapy in cases of psoriasis and other dermatoses due to the excellent results obtained. However, in Korea many patients receiving phototherapy have complained about the tanning effect of ultraviolet radiation. OBJECTIVE: The aim of this study was to determine the time-course of pigmentation induced by phototherapy during and after narrow-band UVB treatment. METHODS: Changes in skin color were recorded during phototherapy in 40 patients and after treatment in 20 patients. All patients were Korean and were evaluated during 10 weeks of phototherapy (three sessions per week), and then weekly post-phototherapy using two different reflectance spectrophotometers for 10 weeks. Results are presented as erythema (E)- and melanin (M)-indexes and as L*a*b* values as recommended by the Commission Internationale de l'Eclairge and individual typology angle (ITA). RESULTS: L* values, which indicate luminance, decreased continuously over the 5 weeks of phototherapy and showed a plateau after 5 weeks of treatment, and then slowly recovered over 10 weeks of post-treatment observation. Patterns of a* and b* values were comparable with L* values both during and after therapy. Mean ITA values also showed a pattern similar to L* values. E and M indexes changed slowly both during and post-phototherapy. In addition, when data were analyzed by skin type, the different skin types showed temporal patterns similar to the overall skin values, but the L* values and ITA and M indexes of skin type III recovered faster than those of skin types IV or V. CONCLUSION: This study shows that pigmentation induced by narrow-band UVB phototherapy increases continuously during the therapy and that recovery requires 10 weeks or more.

Adult↗
PubMed1981

Insensible water loss in the critically III neonate. Combined effect of radiant-warmer power and phototherapy.

To quantitate radiant power and insensible water loss under phototherapy, 12 neonates were studied under radiant warmers for one hour each with and without phototherapy. Warmer power was measured by wattmeter and thermopile. Power density received from phototherapy was 4.4 mW/sq cm. Addition of phototherapy to the servocontrolled warmer caused a disease in power density received from the warmer (17.1 to 12.9 mW/sq cm). However, the total radiant-power density received with phototherapy and the warmer combined (17.3 mW/sg cm) did not differ from net power density received without phototherapy (17.1 mW/sq cm). Insensible water loss, measured with a metabolic balance, increased from 2.54 to 3.73 mL/kg/hr, with addition of phototherapy. Since the total radiant-power density did not change, mechanisms other than increased radiant-power delivery must exist to explain the increased insensible water loss observed with phototherapy.

Female↗
PubMed2002

Nitric oxide production in newborns under phototherapy.

Nitrogen monoxide (NO) is a potent endogenous vasodilator and is involved in cytotoxicity, neurotransmission, and immunological defense mechanisms. Phototherapy has long been known to change the distribution of blood flow throughout the body in newborn infants. The objective of this study was to investigate the effect of phototherapy on NO production in otherwise healthy newborns. Urinary NO levels were measured before and 6 h after phototherapy by a chemiluminescence method using Sievers NOA. Ten newborns (gestational age, 36.4 +/- 3.9 weeks; birth weight, 2863 +/- 677.44 g; postnatal age, 5.1 +/- 2.72 days) were started on phototherapy according to AAP guidelines and urine for NO measurement was collected prior to therapy and 6 h after the commencement of treatment. Urinary NO levels measured during phototherapy were significantly higher (108.8+/-50.69 micromol/mmol creatinine) than the levels measured before phototherapy (73.13+/-34.15 micromol/mmol creatinine; P < 0.05). These results suggest that newborns receiving phototherapy might have increased NO production, which might result in hemodynamic changes. However, further studies on the effects of phototherapy on NO and photorelaxation are needed before reaching firm conclusions.

Blood Pressure↗
PubMedDate not supplied

Antioxidant defense systems in newborns undergoing phototherapy.

This paper was designed to investigate whether phototherapy is an oxidative stress in newborn infants undergoing phototherapy. A day-light continuous phototherapy was given to jaundiced 20 term and 16 preterm newborns for 72 hours. We measured serum vitamin E and the activities of red blood cell anti-oxidation enzymes (superoxide dismutase, catalase and glutathione peroxidase) before and after 72 h of phototherapy. Serum vitamin E levels were not different before and after 72 h of phototherapy in both preterm and term infants. In several studies, antioxidant enzyme activities have been shown to increase in response to oxidative stresses. In this study, however, the antioxidant enzyme activities in the hemolysate were similar before and at the end of the phototherapy in both preterm and full term. In conclusion, the results of our in vivo study do not confirm the thesis that phototherapy is an oxidative stress in newborn infants. Therefore, phototherapy would preferably seem to be safe and efficient method of treatment for all neonates presenting with hyperbilirubinemia.

Humans↗
PubMed1999

Medium-dose UVA1 cold-light phototherapy in the treatment of severe atopic dermatitis.

BACKGROUND: Recently, conventional high-dose UVA1 phototherapy (340-400 nm) has been shown to be more effective than combined UVA-UVB therapy in the treatment of severe atopic dermatitis (AD). However, there are limitations of this treatment, such as intense sweating caused by the immense heat load during therapy and the high cumulative UVA1 doses that are required. For this reason, lavish UVA1 equipment was developed containing an advanced filtering and cooling system resulting in almost complete absence of heat load and sweating during therapy. OBJECTIVE: In this study we compared the monotherapeutic efficacy of conventional medium-dose UVA1, medium-dose UVA1 cold-light, and combined UVA-UVB phototherapy in the treatment of severe AD. METHOD: The study involved 120 patients with severe AD. Fifty patients each received conventional UVA1 or UVA1 cold-light phototherapy (15 days, 50 J/cm(2)/day), and 20 patients were treated with combined UVA-UVB (15 days, minimal erythema dose dependent). Severity of AD was scored by means of the SCORAD score, and clinical improvement was additionally monitored by serologic cytokine markers. RESULTS: Six (12%) of 50 patients treated with UVA1, 2 (4%) of 50 patients treated with UVA1 cold-light therapy, and 4 (20%) of 20 patients treated with combined UVA-UVB therapy discontinued treatment prematurely because of an unsatisfactory clinical outcome or adverse reactions. Skin status improved or even cleared completely in 77.3% of the patients treated for 3 weeks with conventional UVA1 therapy and in 85.4% of the patients treated for 3 weeks with UVA1 cold-light therapy, resulting in a significant decrease in the SCORAD score in both UVA1 groups (P <.05 each). In the group treated with combined UVA-UVB, the SCORAD score also decreased but significantly less than in both groups treated with UVA1 photo-therapy (P <.05 each). At follow-up after 4 weeks, the patients treated with UVA1 displayed a more prolonged therapeutic benefit than the patients treated with UVA-UVB therapy. Plasma levels of soluble interleukin 2 receptors and soluble interleukin 4 receptors significantly decreased under both UVA1 and UVA1 cold-light phototherapy but not under combined UVA-UVB phototherapy. CONCLUSION: Our study demonstrates that medium-dose UVA1 cold-light phototherapy displays advantages compared with conventional UVA1 phototherapy caused by the almost complete absence of heat load and intense sweating and is more effective than UVA-UVB phototherapy in the treatment of severe AD.

Adolescent↗
PubMedDate not supplied

Effect of position changing on bilirubin levels during phototherapy.

OBJECTIVE: Turning of infants during phototherapy for hyperbilirubinemia is practiced in many nurseries. However, there is little research evidence in support of this practice. This study examined the effect of turning on serum total bilirubin concentration and on the duration of phototherapy. STUDY DESIGN: We first conducted a pilot study in term infants requiring phototherapy using transcutaneous bilirubinometry in order to determine the time required to clear the skin of bilirubin. This "blanching time" was found to be approximately 150 minutes. We then conducted a randomized study comparing turning the baby during phototherapy with care in the supine position only. RESULTS: Thirty term infants were enrolled in the study (turned - 14; supine - 16). No differences were found between the groups in baseline data, such as birth weight, gestational age, age at start of phototherapy, or type of feeds. Infants in the supine group showed a significantly larger drop in serum total bilirubin concentration and required a shorter duration of phototherapy. CONCLUSION: We conclude that infants should be nursed supine during phototherapy. Based on these results, we propose a modification to the traditional model of bilirubin kinetics during phototherapy.

Bilirubin↗
PubMed2005

Does prophylactic phototherapy prevent hyperbilirubinemia in neonates with ABO incompatibility and positive Coombs' test?

OBJECTIVE: The objective of the study was to determine whether initiation of early phototherapy in positive direct Coombs' test (DCT) with ABO-incompatible newborns would prevent severe jaundice. STUDY DESIGN: A prospective controlled study was performed at Al Qassimi Hospital. Infants born at term and weighing >2000 g with ABO incompatibility and a positive DCT were included in the study. Within their first 4 hours of life and after parental consent, infants were enrolled into one of two groups: prophylactic phototherapy group, which received phototherapy during the first 24 hours of life (group I), or no prophylactic phototherapy, which represents the control group (group II). Selection of infants to either group was by 2-week alternative strategy. Blood group, complete blood count (CBC), reticulocyte count, blood smears, total serum bilirubin (TSB) and DCT were performed on cord blood of all neonates born to mothers with O-positive blood group. CBC, reticulocytes and TSB level were obtained in all enrolled infants at 12, 24, 48, 72, and 96 hours of life. RESULTS: During the study period, 242 newborns with positive DCT were enrolled. A total of 102 infants were allocated to the prophylactic phototherapy arm and 140 as controls. Prophylactic phototherapy was associated with a significant decrease in the TSB at 24 hours (p=0.002) and at 48 hours (p=0.003) but not later on. The total number of patients who had hyperbilirubinemia at any time during the first 96 hours was significantly less in the prophylactic group (17 vs 45--p=0.006). Prolonged hospital stay because of phototherapy was more frequent in the control group (p=0.03). CONCLUSION: Prophylactic phototherapy was associated with a significant reduction of TSB in the first 48 hours of life but not later on. Clinical benefits of this strategy could not be proven.

ABO Blood-Group System↗
PubMed1999

Optimizing therapy: tazarotene in combination with phototherapy.

Phototherapy is often used in combination with other antipsoriatic treatments in an attempt to improve efficacy and reduce patients' cumulative exposure to radiation. Although this aim has been achieved with some combinations, the additional therapies often introduce a potential risk of other tolerability and safety problems. The efficacy of tazarotene reported in clinical trials to date suggest that this drug may help to improve the efficacy of phototherapy, and perhaps reduce the ultraviolet light exposure required without introducing additional, clinically significant problems. Preliminary results from the first 10 patients in a clinical trial investigating such combination therapy are reported here. They demonstrate that the addition of tazarotene to UVB phototherapy increases the percentage of patients achieving treatment success (> or = 50% global improvement in psoriasis) from 60% to 100% at Day 81. The UVB plus tazarotene combination achieved consistently greater reductions in the elevation and scaling of difficult-to-treat psoriatic plaques than UVB phototherapy alone or UVB phototherapy plus vehicle gel. The tazarotene combination therapy also achieved initial treatment success in less than half the time needed with phototherapy alone (median of 32 vs. 67 days). Combining UVB phototherapy with tazarotene treatment appears to offer a valuable therapeutic option that is more efficacious and faster than UVB phototherapy alone.

Adult↗
PubMed2004

Phototherapy: current methods and future directions.

Phototherapy is the most common therapeutic intervention used for the treatment of hyperbilirubinemia. Although it has become a mainstay since its introduction in 1958, a better understanding of the photobiology of bilirubin, characteristics of the phototherapy devices, the efficacy and safety considerations of phototherapy applications, and improvements in spectroradiometers and phototherapy devices are necessary for more predictable and improved clinical practices and outcomes. A step forward in instituting consistent, uniform, and effective use of phototherapy is the recent American Academy of Pediatrics clinical guideline on the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, which outlines a clinical strategy for the diagnosis of hyperbilirubinemia and contains direct recommendations for the application of phototherapy. This article reviews the parameters that determine the efficacy of phototherapy, briefly discusses current devices and methods used to deliver phototherapy, and speculates on future directions and studies that are still needed to complement our presently incomplete knowledge of the facets of this common mode of therapy.

Bilirubin↗
PubMed1998

The effect of phototherapy on cerebral blood flow velocity in preterm infants.

Cerebral blood flow velocity was studied with two-dimensional/pulsed Doppler ultrasound before, during and after discontinuation of phototherapy in 22 preterm infants (gestational age < or =32 weeks), who were treated for a minimum of 12h with blue-light phototherapy for non-haemolytic hyperbilirubinaemia. Before the cerebral blood flow velocity measurements, patency of the ductus arteriosus was diagnosed by Doppler echocardiography. All infants had normal brain ultrasound scans. Mean cerebral blood flow velocity increased significantly after initiation of phototherapy in all infants. Only in "healthy" (non-ventilated) infants did cerebral blood flow velocity return to pre-phototherapy values (baseline) after discontinuation of phototherapy, whereas in "unhealthy" (ventilated) infants cerebral blood flow velocity did not return to baseline. In 10 infants the ductus arteriosus reopened during phototherapy. In those infants, mean cerebral blood flow velocity returned to pre-phototherapy values after 2 h of phototherapy prior to its discontinuation.

Blood Flow Velocity↗
PubMedDate not supplied

Effects of phototherapy on the growth plate in newborn rats.

The aim of the present study was to evaluate the effect of phototherapy and oxidative stress on the growth plate of newborn rats. Forty newborn Sprague-Dawley rats were randomized into a phototherapy group and a control group. Twenty of the rats received phototherapy for 7 days. All zones of the growth plate were assessed with quantitative histomorphometric analysis. Individual zonal lengths were measured for the reserve zone (RZ), the proliferative zone (PZ), the hypertrophic zone (HZ), ossifying cartilage (OC), and total zone (TZ) of the growth plate. Levels of plasma malondialdehyde (MDA), an index of oxidative stress, were also evaluated. Compared with zonal lengths on day 7 after phototherapy between the two groups, the phototherapy group had significantly lower values than those of controls for RZ (5.13 +/- 0.36 vs. 6.4 +/- 0.85 mm x 10(-2); P < 0.001), PZ (20.6 +/- 3.0 vs. 29.25 +/- 1.68 mm x 10(-2); P < 0.001), HZ (15.4 +/- 1.44 vs. 20.87 +/- 1.12 mm x 10(-2); P < 0.001), OC (47.08 +/- 4.25 vs. 62.06 +/- 3.7 mm x 10(-2); P < 0.001), and TZ (88.15 +/- 6.56 vs. 118.48 +/- 4.50 mm x 10(-2); P < 0.001). Plasma MDA levels were correlated with the size of the PZ in the phototherapy group (r = -0.53, P = 0.01). In a multivariate regression model for all rats, being in the phototherapy group was the best predictor of the size of the TZ (beta = -0.94, P < 0.001), with the total variance explained being 88%. These results suggest that in newborn rats, receiving phototherapy is associated with early impairment of growth plate structure, and oxidative stress may be the main risk factor for growth plate injury.

Animals↗