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1.
J Photochem Photobiol B ; 207: 111891, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32388486

RESUMO

The recent outbreak of COVID-19, which continues to ravage communities with high death tolls and untold psychosocial and catastrophic economic consequences, is a vivid reminder of nature's capacity to defy contemporary healthcare. The pandemic calls for rapid mobilization of every potential clinical tool, including phototherapy-one of the most effective treatments used to reduce the impact of the 1918 "Spanish influenza" pandemic. This paper cites several studies showing that phototherapy has immense potential to reduce the impact of coronavirus diseases, and offers suggested ways that the healthcare industry can integrate modern light technologies in the fight against COVID-19 and other infections. The evidence shows that violet/blue (400-470 nm) light is antimicrobial against numerous bacteria, and that it accounts for Niels Ryberg Finsen's Nobel-winning treatment of tuberculosis. Further evidence shows that blue light inactivates several viruses, including the common flu coronavirus, and that in experimental animals, red and near infrared light reduce respiratory disorders, similar to those complications associated with coronavirus infection. Moreover, in patients, red light has been shown to alleviate chronic obstructive lung disease and bronchial asthma. These findings call for urgent efforts to further explore the clinical value of light, and not wait for another pandemic to serve as a reminder. The ubiquity of inexpensive light emitting lasers and light emitting diodes (LEDs), makes it relatively easy to develop safe low-cost light-based devices with the potential to reduce infections, sanitize equipment, hospital facilities, emergency care vehicles, homes, and the general environment as pilot studies have shown.


Assuntos
Infecções por Coronavirus/terapia , Fototerapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Helioterapia , Humanos , Raios Infravermelhos , Luz , Terapia com Luz de Baixa Intensidade , Pneumopatias/epidemiologia , Pneumopatias/terapia , Pneumopatias/virologia , Pandemias , Fototerapia/métodos , Pneumonia Viral
2.
Int J Biometeorol ; 64(7): 1145-1152, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32133542

RESUMO

This study assessed the effects of liman peloid, followed by bath and heliotherapy in psoriatic patients at Cervia, Emilia, Italy. The psoriatic patients were randomized into two groups: group 1 with 56 patients, treated with liman applications, bath, and heliotherapy, and group 2 with 35 subjects, treated with mud-bath therapy using a clay peloid mixed with tap water and heliotherapy. Data was collected for the following: psoriasis area and severity index (PASI); delta-PASI (difference between post- and pre-treatment PASI); delta-PASI3 and delta-PASI6, 3 and 6 months after the end of treatment, respectively; psoriasis recurrences; and the use of both topical and systemic drugs. Although not significant, a decrease in PASI was recorded in group 1 at the end of treatment and after 3 and 6 months. Compared with group 2, there was a significant change in delta-PASI, delta-PASI3, and psoriasis recurrences in group 1 as well as a significant reduction in the topical use of drugs, both cortisone and nonsteroid drugs. This is the first and preliminary study which documented the efficacy of a specific protocol of liman bath heliotherapy in psoriatic patients as documented by a reduction in delta-PASI and delta-PASI3, a decrease in psoriasis recurrences, and use of topical drugs.


Assuntos
Helioterapia , Psoríase , Banhos , Humanos , Itália , Índice de Gravidade de Doença , Resultado do Tratamento
3.
Pediatr Dermatol ; 36(5): 690-692, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31313355

RESUMO

Lichen nitidus is a benign inflammatory dermatosis that typically presents in a localized distribution. We present the rare case of a 6-year-old boy with a 1-year history of generalized lichen nitidus with limited access to narrowband ultraviolet B phototherapy. Over the course of a summer, he had complete and lasting resolution of generalized lichen nitidus after daily natural sunlight exposure. This case demonstrates a rare variant of lichen nitidus and a practical treatment alternative to in-office phototherapy.


Assuntos
Helioterapia , Líquen Nítido/terapia , Criança , Humanos , Masculino
4.
Int J Dermatol ; 58(4): 472-476, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30506679

RESUMO

BACKGROUND: Noncultured epidermal cell suspension (NCES) is an effective surgical modality for stable vitiligo which involves transplantation of the basal layer of epidermal cells onto the dermabraded vitiliginous patch. Platelet-rich plasma (PRP) has growth factors which may stimulate melanocyte migration and proliferation of keratinocytes and fibroblasts. The objective of this study was to compare the extent of repigmentation achieved by transplantation of NCES suspended in PRP with that of NCES suspended in phosphate buffered saline (PBS). METHODS: Twenty-one patients of stable vitiligo with at least two lesions of comparable size were included. The two vitiligo patches were randomized to receive NCES suspended in PRP or PBS. Postoperatively after 1 week, patients were given heliotherapy for 15 minutes daily. RESULTS: At 6 months follow-up, mean repigmentation by area method in PRP arm was 75.6 ± 30% SD and in non-PRP arm was 65 ± 34% SD (P = 0.0036). Patient satisfaction by visual analogue scale at 6 months also showed better results in PRP arm (P = 0.001). Assessment by three independent observers showed better repigmentation in PRP side both at 3 and 6 months. CONCLUSIONS: Suspending NCES in PRP can result in significantly greater mean repigmentation and patient satisfaction than suspending in PBS.


Assuntos
Células Epidérmicas/transplante , Plasma Rico em Plaquetas , Pigmentação da Pele , Vitiligo/terapia , Adolescente , Adulto , Método Duplo-Cego , Feminino , Helioterapia , Humanos , Masculino , Satisfação do Paciente , Solução Salina , Transplante Autólogo/métodos , Resultado do Tratamento , Adulto Jovem
6.
Acta Derm Venereol ; 98(2): 256-261, 2018 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-28815268

RESUMO

Dead Sea climatotherapy (DSC) is a therapeutic modality for a variety of chronic skin conditions, yet there has been scarce research on the relationship between the cutaneous microbiota and disease states in response to DSC. We characterized the skin bacterial and fungal microbiome of healthy volunteers who underwent DSC. Bacterial community diversity remained similar before and after treatment, while fungal diversity was significantly reduced as a result of the treatment. Individuals showed greater inter-individual than temporal bacterial community variance, yet the opposite was true for fungal community composition. We further identified Malassezia as the genus driving temporal mycobiome variations. The results indicate that the microbiome remains stable throughout DSC, while the mycobiome undergoes dramatic community changes. The results of this study will serve as an important baseline for future investigations of microbiome and mycobiome temporal phenomena in diseased states.


Assuntos
Bactérias/crescimento & desenvolvimento , Balneologia/métodos , Climatoterapia/métodos , Fungos/crescimento & desenvolvimento , Helioterapia/métodos , Microbiota , Pele/microbiologia , Bactérias/classificação , Feminino , Fungos/classificação , Voluntários Saudáveis , Humanos , Israel , Malassezia/crescimento & desenvolvimento , Masculino , Micobioma , Fatores de Tempo
7.
Early Hum Dev ; 114: 11-15, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28919246

RESUMO

Challenges in treating severe neonatal jaundice in low and middle-income country settings still exist at many levels. These include: a lack of awareness of causes and prevention by families, communities and even sometimes health care professionals; insufficient, ineffective, high quality affordable diagnostic and therapeutic options; limited availability of rehabilitation provision for kernicterus. Collectively these challenges lead to an unacceptably high global morbidity and mortality from severe neonatal jaundice. In the past decade, there has been an explosion of innovations addressing some of these issues and these are increasingly available for scale up. Scientists, healthcare providers, and communities are joining hands to explore educational tools, low cost screening and diagnostic options including at point-of-care and treatment modalities including filtered sunlight and solar powered phototherapy. For the first time, the possibility of eliminating the tragedy of preventable morbidity and mortality from severe NNJ is on the horizon, for all.


Assuntos
Helioterapia/métodos , Icterícia Neonatal/prevenção & controle , Fototerapia/métodos , Países em Desenvolvimento , Feminino , Helioterapia/economia , Humanos , Recém-Nascido , Icterícia Neonatal/diagnóstico , Icterícia Neonatal/epidemiologia , Icterícia Neonatal/terapia , Fototerapia/economia
9.
Acta Derm Venereol ; 97(8): 934-940, 2017 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-28536730

RESUMO

Alexithymia, defined as difficulty in describing or recognizing emotions, has been shown to be connected with psoriasis, but its relationship with self-management of psoriasis has not been explored. The aim of this study was to assess the frequency of alexithymia and its relationship with self-management and illness perception in the context of psoriasis. A total of 163 patients participating in 3 weeks of climate heliotherapy (CHT) at Gran Canaria were assessed for alexithymia using the Toronto Alexithymia Scale (TAS-20) at baseline. Self-reported measures for self-management (Health Education Impact Questionnaire; heiQ), and disease severity and illness perception (Brief Illness Perception Questionnaire; BIPQ) were assessed twice. Of all patients, 14.1% were characterized as alexithymic and 22.1% scored in the intermediate range. Alexithymic patients scored significantly worse in all heiQ domains, and reported worse illness perception. However, there were no between-group differences in heiQ or BIPQ change from baseline to after CHT. In conclusion, this study shows that alexithymia indicates inferior self-management and reaffirms the associations with illness perception. Further research is required into these relationships.


Assuntos
Sintomas Afetivos/psicologia , Sintomas Afetivos/terapia , Helioterapia , Entrevista Motivacional , Psoríase/psicologia , Psoríase/terapia , Autocuidado/métodos , Autoimagem , Adulto , Sintomas Afetivos/diagnóstico , Idoso , Efeitos Psicossociais da Doença , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Psoríase/diagnóstico , Qualidade de Vida , Autorrelato , Índice de Gravidade de Doença , Suécia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Photochem Photobiol Sci ; 16(3): 416-425, 2017 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-28102417

RESUMO

The Ultraviolet (UV) radiation contained in sunlight is a powerful mutagen and immune suppressant which partly explains why exposure to solar UV is the biggest risk factor for the development of cutaneous tumours. Evidence is building that sunlight may be protective against some internal malignancies. Because patients with these tumours are often vitamin D deficient, this has led some to propose that vitamin D supplementation will be beneficial in the treatment of these cancers. However, the results from already completed trials have been disappointing which has given weight to the argument that there must be something else about sunlight that explains its cancer-protecting properties.


Assuntos
Helioterapia , Neoplasias Cutâneas/terapia , Luz Solar , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Suplementos Nutricionais , Humanos , Neoplasias Cutâneas/complicações , Falha de Tratamento , Vitamina D/administração & dosagem , Deficiência de Vitamina D/complicações
11.
J R Coll Physicians Edinb ; 47(3): 276-280, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29465107

RESUMO

Since the 18th century tuberculosis has been a major cause of death throughout the world. It is a highly infectious disease that spreads by droplet infection and finding effective treatment to combat tuberculosis took a great deal of time. One of the first treatments to have some real success was a stay in a sanatorium. Sanatoria were homes that provided patients with good food and fresh air (and therefore sunlight). The first sanatorium to use sunlight therapy (heliotherapy) seriously was founded in Leysin, Switzerland, by Auguste Rollier. Patients built up their sun exposure gradually to prevent sunburn or skin damage. We suggest that heliotherapy was more successful in treating tuberculosis than was appreciated once chemotherapy became available. The birth of heliotherapy coincided with an increased appreciation of the association of sunlight and health among the general public. The secret of its success is the combined effects of sunlight on the skin inducing the production of nitric oxide and vitamin. Nitric oxide is not only a messenger in the cardiovascular system and responsible for relaxation of vascular muscle but is also involved in the innate immune system. Vitamin D is responsible for immune system functions and multiple studies have found an association between tuberculosis immunity and high vitamin D levels. Therefore, it is understandable that providing tuberculosis patients with sunlight may have boosted their immune system and aided them in the fight against tuberculosis. In view of the high level of resistance to all drug regimens in some patients, perhaps it is time to revive the use of sanatoria in the fight against tuberculosis.


Assuntos
Helioterapia , Hospitais , Luz Solar , Tuberculose/terapia , Helioterapia/história , História do Século XIX , História do Século XX , História Medieval , Hospitais/história , Humanos , Óxido Nítrico/metabolismo , Pele/metabolismo , Tuberculose/história , Tuberculose/metabolismo , Vitamina D/metabolismo
13.
Photochem Photobiol Sci ; 16(3): 426-432, 2017 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-27921098

RESUMO

BACKGROUND: Myopia is a major public health concern throughout the world and the prevalence has been increasing rapidly in recent years, especially in urban Asia. The "vitamin D hypothesis" has been raised recently because vitamin D may be a link between less time outdoors and increased risk of myopia. METHODS: We reviewed all studies published in English which examined the association of time outdoors and blood vitamin D status with myopia. RESULTS: The protective effect of time spent outdoors on the risk of myopia onset has been well-established with numerous observational studies and three trials published. Five studies reporting the association between the blood vitamin D status and the risk of myopia and two studies examining the variations in the vitamin D receptor as potential risk factors for myopia development were identified. Most of the current evidence was cross-sectional in nature and had not properly controlled important confounders in its analyses. The evidence supporting that vitamin D played a role in myopia development is weak and the mechanisms are unclear. CONCLUSIONS: At the current stage, it is still unclear whether blood vitamin D status regulates the onset or progression of myopia. Blood vitamin D status may only serve as a biomarker of outdoor exposure, which is the real protective factor for myopia.


Assuntos
Helioterapia , Miopia/sangue , Miopia/prevenção & controle , Luz Solar , Vitamina D/sangue , Humanos , Receptores de Calcitriol/sangue , Fatores de Risco
15.
Clin Dermatol ; 34(5): 532-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27638430

RESUMO

From ancient times, light has played a significant role in the treatment of diseases. The modern discoveries (eg, ultraviolet radiation) and modern inventions (eg, the electric generator or the electric lightbulb), as well as balneologic experiences of the treatment with sunlight, contributed to the transition from heliotherapy to artificial light phototherapy at the end of the 19th century. Nils Ryberg Finsen (1860-1904) was the founder of modern phototherapy. He is famous for applying an electric carbon arc torch in treating patients with lupus vulgaris using ultraviolet radiation. Subsequently, phototherapy using artificial light sources gained importance in the treatment of skin diseases with a noninfectious etiology. William Henry Goeckerman (1884-1954) chose an ultraviolet B light to treat psoriasis. Improvement in the effectiveness of dermatologic phototherapy occurred in 1947, when methoxypsoralen was isolated. During the 20th century, phototherapy was applied to new therapeutic areas, such as neonatology, psychiatry, and ophthalmology.


Assuntos
Dermatologia/história , Fototerapia/história , Dermatopatias/terapia , Dermatologia/métodos , Helioterapia/história , História do Século XV , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , Humanos
16.
Clin Dermatol ; 34(5): 587-93, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27638437

RESUMO

Psoriasis is a chronic and common disease mediated by resident memory T cells that negatively affects a broad range of people worldwide. One of the oldest and most commonly used treatments is phototherapy. We reviewed the existing literature on the four main ultraviolet B (UVB) modalities of phototherapy in the management of psoriasis: heliotherapy, broadband UVB, narrowband UVB, and excimer laser and lamp. Despite the many studies done on these therapies, there is significant variation in their prescription and use. Phototherapy remains one of the most effective and safest treatments for psoriasis. We provide an updated comprehensive overview of UVB phototherapy for psoriasis to help physicians optimize their choice of modality and dosing regimen to ensure optimal outcomes for psoriasis patients. © 2016 Elsevier Inc. All rights reserved.


Assuntos
Helioterapia , Lasers de Excimer/uso terapêutico , Psoríase/radioterapia , Terapia Ultravioleta/métodos , Contraindicações , Humanos , Seleção de Pacientes , Terapia Ultravioleta/efeitos adversos
18.
Br J Dermatol ; 175(4): 768-75, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27030101

RESUMO

BACKGROUND: Erythropoietic protoporphyria (EPP) is a rare metabolic disorder, characterized by photosensitivity, caused by errors of the haem biosynthetic pathway. Avoidance of sun exposure is recommended; however, some patients suggested a paradoxical improvement of symptoms when they move to sunny areas. OBJECTIVES: In a national French study, we sought to investigate the influence of sun exposure on EPP symptoms. MATERIALS AND METHODS: We used a national transversal observational study by questionnaire. Patients were selected from the national record of the Centre Français des Porphyries (French Porphyrias referral centre). Sun exposure level by geographic area was assessed using climate data provided by the French national meteorological service (Météo France). RESULTS: Eighty-nine patients were included. We notably observed that 40% of patients declared an improvement in their tolerance of sun exposure after repeated sun exposures. In the more sunny areas, the intensity of the pain was lower (r = -0·26) and the duration of the sun exposure responsible for flares was longer (r = 0·39) than in the areas that were less sunny (P < 0·05). CONCLUSIONS: This study proposes a benefit of natural progressive sun exposure for patients with EPP.


Assuntos
Transtornos de Fotossensibilidade/epidemiologia , Protoporfiria Eritropoética/epidemiologia , Luz Solar , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Vestuário , Exposição Ambiental/estatística & dados numéricos , Feminino , França/epidemiologia , Helioterapia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Transtornos de Fotossensibilidade/prevenção & controle , Protoporfiria Eritropoética/prevenção & controle , Protetores Solares/uso terapêutico , Tempo (Meteorologia) , Adulto Jovem
19.
PLoS One ; 11(3): e0151375, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27003893

RESUMO

BACKGROUND: A novel filtered-sunlight phototherapy (FSPT) device has been demonstrated to be safe and efficacious for treating infants with neonatal jaundice in resource-constrained tropical settings. We set out to provide baseline data for evaluating the clinical impact of this device in a referral pediatric hospital. METHODS: We reviewed the medical records of infants admitted for neonatal hyperbilirubinemia in an inner-city Children's Hospital in Lagos, between January 2012 and December 2014 to determine the pattern, treatment and outcomes during the pre-intervention period. Factors associated with adverse outcomes were identified through multivariable logistic regression. RESULTS: Of the 5,229 neonatal admissions over the period, a total of 1,153 (22.1%) were admitted for neonatal hyperbilirubinemia. Complete records for 1,118 infants were available for analysis. The incidence of acute bilirubin encephalopathy (ABE) and exchange transfusion (ET) were 17.0% (95% CI: 14.9%-19.3%) and 31.5% (95% CI: 28.8%-34.3%) respectively. A total of 61 (5.5%, 95% CI: 4.3%-6.9%) of the jaundiced infants died. Weight on admission, peak total serum bilirubin (TSB), sepsis and exposure to hemolytic products were predictive of ABE, while age on admission, peak TSB, ABO incompatibility and ABE were predictive of ET. Rhesus incompatibility, asphyxia, exposure to hemolytic substances and ABE were associated with elevated mortality risk, while ET was a protective factor. Lack of routine irradiance monitoring and steady energy supply were frequent challenges for conventional blue-light phototherapy. CONCLUSIONS: Severe hyperbilirubinemia is associated with high rates of ABE and ET in this setting, and remains a significant contributor to neonatal admissions and mortality. To be impactful, FSPT, complemented with improved diagnostic facilities, should effectively curtail jaundice-related adverse outcomes in this and comparable settings.


Assuntos
Helioterapia/métodos , Icterícia Neonatal/terapia , Bilirrubina/metabolismo , Incompatibilidade de Grupos Sanguíneos/metabolismo , Transfusão Total/métodos , Feminino , Helioterapia/efeitos adversos , Humanos , Incidência , Recém-Nascido , Icterícia Neonatal/metabolismo , Kernicterus/metabolismo , Kernicterus/terapia , Modelos Logísticos , Masculino , Nigéria , Fototerapia/efeitos adversos , Fototerapia/métodos , Luz Solar
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