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1.
Biol Pharm Bull ; 47(6): 1066-1071, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38825459

RESUMO

Both nuclear and optical imaging are used for in vivo molecular imaging. Nuclear imaging displays superior quantitativity, and it permits imaging in deep tissues. Thus, this method is widely used clinically. Conversely, because of the low permeability of visible to near-IR light in living animals, it is difficult to visualize deep tissues via optical imaging. However, the light at these wavelengths has no ionizing effect, and it can be used without any restrictions in terms of location. Furthermore, optical signals can be controlled in vivo to accomplish target-specific imaging. Nuclear medicine and phototherapy have also evolved to permit targeted-specific imaging. In targeted nuclear therapy, beta emitters are conventionally used, but alpha emitters have received significant attention recently. Concerning phototherapy, photoimmunotherapy with near-IR light was approved in Japan in 2020. In this article, target-specific imaging and molecular targeted therapy utilizing nuclear medicine and optical technologies are discussed.


Assuntos
Imagem Molecular , Medicina Nuclear , Imagem Óptica , Humanos , Animais , Imagem Óptica/métodos , Imagem Molecular/métodos , Medicina Nuclear/métodos , Fototerapia/métodos , Terapia de Alvo Molecular/métodos , Neoplasias/terapia , Neoplasias/diagnóstico por imagem
2.
J Drugs Dermatol ; 23(6): 472-476, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38834210

RESUMO

The debate surrounding the benefits versus harms of blue light have become a topic of interest recently due to increased exposure. Blue light therapy has been utilized with some success in a variety of dermatologic conditions. However, potential harms have also been documented. Currently, there is no evidence to suggest a necessity for blue light photoprotection, but there are products available with proven efficacy for those desiring protection. J Drugs Dermatol. 2024;23(6):472-476.     doi:10.36849/JDD.7665.


Assuntos
Luz , Pele , Humanos , Luz/efeitos adversos , Pele/efeitos da radiação , Dermatopatias/etiologia , Dermatopatias/terapia , Fototerapia/métodos , Fototerapia/efeitos adversos , Luz Azul
3.
Med Mycol ; 62(5)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38692846

RESUMO

Candida albicans is a pathogenic fungus that undergoes morphological transitions between hyphal and yeast forms, adapting to diverse environmental stimuli and exhibiting distinct virulence. Existing research works on antifungal blue light (ABL) therapy have either focused solely on hyphae or neglected to differentiate between morphologies, obscuring potential differential effects. To address this gap, we established a novel dataset of 150 C. albicans-infected mouse skin tissue slice images with meticulously annotated hyphae and yeast. Eleven representative convolutional neural networks were trained and evaluated on this dataset using seven metrics to identify the optimal model for segmenting hyphae and yeast in original high pixel size images. Leveraging the segmentation results, we analyzed the differential impact of blue light on the invasion depth and density of both morphologies within the skin tissue. U-Net-BN outperformed other models in segmentation accuracy, achieving the best overall performance. While both hyphae and yeast exhibited significant reductions in invasion depth and density at the highest ABL dose (180 J/cm2), only yeast was significantly inhibited at the lower dose (135 J/cm2). This novel finding emphasizes the importance of developing more effective treatment strategies for both morphologies.


We studied the effects of blue light therapy on hyphal and yeast forms of Candida albicans. Through image segmentation techniques, we discovered that the changes in invasion depth and density differed between these two forms after exposure to blue light.


Assuntos
Candida albicans , Hifas , Animais , Camundongos , Candida albicans/efeitos da radiação , Pele/microbiologia , Fototerapia/métodos , Processamento de Imagem Assistida por Computador/métodos , Luz , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Redes Neurais de Computação , Modelos Animais de Doenças , Candidíase/microbiologia
4.
PLoS One ; 19(5): e0304290, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38787841

RESUMO

The aim of the study was to assess the impact of solarium light therapy on selected biological and biochemical parameters of peripheral blood in recreational horses. The study involved 10 horses divided into two groups of young (aged 5 to 7 years) and old (aged 14 to 19 years) individuals. All animals participated in light therapy sessions every other day. Blood was sampled three times during the study: before the treatment, after five light sessions, and after ten light sessions. Morphological parameters, the activity of antioxidant enzymes, TAS values, and the levels of glutathione (GSH), vitamin D3, vitamin C, and malondialdehyde (MDA) were measured in the whole blood. Light therapy contributed to an increase in MCV, HDW, MCVr, CHr and MPV indices, and simultaneously a decrease in the basophil counts, MCHC, RDW and CHCMr indices in both groups of horses (p ≤ 0.05). At the same time reticulocytes fell in older whereas white blood cells and monocytes counts expanded in younger individuals. The treatment also increased the activity of glutathione reductase (GR) and glutathione peroxidase (GPx) in young but decreased the activity of mentioned enzymes in blood plasma of old horses. The total antioxidant status (TAS) of the blood plasma rose progressively, whereas GSH levels declined in all individuals. Moreover, vitamin D3 levels did not change, whereas vitamin C levels gradually decreased during the experiment. The therapy also helped to reduce levels of MDA in the blood plasma, especially of older horses (p ≤ 0.05). In turn, GPx and GR activities as well as MDA levels significantly declined, whereas GSH levels notably elevated in erythrocytes (p ≤ 0.05). Solarium light therapy appears to have a beneficial impact on the morphological parameters and antioxidant status of blood in recreational horses in the winter season. However, the observed results could in part be attributed to the natural physiological adaptation of each individual organism to the treatment.


Assuntos
Antioxidantes , Animais , Cavalos/sangue , Antioxidantes/metabolismo , Glutationa/sangue , Glutationa/metabolismo , Fototerapia/métodos , Malondialdeído/sangue , Ácido Ascórbico/sangue , Masculino , Feminino , Glutationa Redutase/sangue , Glutationa Redutase/metabolismo , Glutationa Peroxidase/sangue , Glutationa Peroxidase/metabolismo , Colecalciferol/sangue , Envelhecimento/sangue
5.
J Dermatolog Treat ; 35(1): 2350231, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38754985

RESUMO

Background: Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma.Objectives: This study was conducted to evaluate efficacy and safety of interferon (IFN) α-2a combined with phototherapy for early-stage MF.Methods: Thirteen patients with early-stage MF received subcutaneous injections of IFN α-2a at 3 million IU combined with phototherapy three times per week for 6 months. Treatment efficacy was measured by changes in body surface area (BSA) score and modified severity-weighted assessment tool (mSWAT) score at 1, 3, and 6 months after treatment. Histopathologic examinations of skin lesions were performed before and after treatment.Results: After 3 months of treatment, all 13 patients achieved a partial response, and BSA and mSWAT scores were significantly lower than those at baseline (p < 0.001). After 6 months, BSA and mSWAT scores were significantly lower than those at baseline (p < 0.001) and after 3 months (p < 0.05). Eleven patients achieved complete remission and two patients achieved a partial response (overall response rate, 100%). Histopathologic examination showed a significant decrease in the number of atypical lymphocytes in both epidermis and dermis. No severe adverse effects occurred.Conclusion: IFN α-2a in combination with phototherapy may be an effective and safe alternative modality for early-stage MF.


Assuntos
Interferon alfa-2 , Interferon-alfa , Micose Fungoide , Neoplasias Cutâneas , Humanos , Micose Fungoide/terapia , Micose Fungoide/patologia , Micose Fungoide/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Prospectivos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Interferon alfa-2/administração & dosagem , Resultado do Tratamento , Idoso , Injeções Subcutâneas , Interferon-alfa/administração & dosagem , Interferon-alfa/efeitos adversos , Terapia Combinada , Fototerapia/efeitos adversos , Estadiamento de Neoplasias , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos
6.
Dermatol Clin ; 42(3): 399-404, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38796271

RESUMO

Phototherapy has utility as a psoriatic therapy, given its relatively high clinical efficacy, low side effect profile, and lower cost compared to newer effective treatments like biologics and small molecules. Phototherapy has shown Psoriasis Area and Severity Index (PASI)-75 and PASI-90 rates comparable to those of biologics and small molecules, with similarly rapid onsets of action, rates of remission, and quality of life scores. Certain patients may particularly benefit from phototherapy, such as those with localized disease or contraindications to systemic immunomodulatory medication. Phototherapy can be more cost-effective than biologics and conveniently administered at home, making it a valuable therapeutic option for the right patient.


Assuntos
Produtos Biológicos , Fototerapia , Psoríase , Humanos , Psoríase/terapia , Psoríase/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Fototerapia/métodos , Índice de Gravidade de Doença , Terapia PUVA/métodos , Terapia Ultravioleta/métodos
7.
Dermatol Clin ; 42(3): 495-506, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38796278

RESUMO

Understanding the underlying causes of nonadherence among patients with psoriasis and adopting strategies to address these issues may allow providers to share responsibility and work alongside patients to overcome these barriers. The review explores patient adherence to different types of psoriasis treatment, suggestions for interventions to overcome barriers, and methods to promote adherence that have been published in the literature.


Assuntos
Fármacos Dermatológicos , Adesão à Medicação , Psoríase , Humanos , Psoríase/terapia , Psoríase/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Educação de Pacientes como Assunto , Fototerapia
8.
J Colloid Interface Sci ; 669: 578-589, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38729006

RESUMO

Stable organic radicals have emerged as a promising option to enhance fluorescence quantum yield (QY), gaining traction in medical treatment due to their unique electronic transitions from the ground state (D0) to the doublet excited state (D1). We synthesized a stable dicyanomethyl radical with a NIR-II fluorescence QY of 0.86 %, surpassing many NIR-II organic dyes. Subsequently, amphiphilic polymer-encapsulated nanoparticles (NPs) containing the radical were created, achieving a NIR-II fluorescence QY of 0.32 %, facilitating high-contrast bio-imaging. These CNPPs exhibit self-enhanced photothermal properties, elevating photothermal conversion efficiency (PCE) from 43.5 % to 57.5 % under 915 nm laser irradiation. This advancement enables more efficient photothermal therapy (PTT) with lower dye concentrations and reduced laser power, enhancing both feasibility and safety. Through regular fractionated mild photothermal therapy, we observed the release of damage-associated molecular patterns (DAMPs) and an increase in cytokine expression, culminating in combined mild phototherapy (m-PTT)-mediated immunogenic cell death (ICD). Consequently, we developed an immunostimulatory tumor vaccine, showcasing a novel approach for refining photothermal agents (PTA) and optimizing the PTT process.


Assuntos
Raios Infravermelhos , Nanopartículas , Peptídeos , Nanopartículas/química , Peptídeos/química , Peptídeos/farmacologia , Animais , Humanos , Camundongos , Nanomedicina Teranóstica , Tamanho da Partícula , Terapia Fototérmica , Fototerapia , Radicais Livres/química , Propriedades de Superfície , Sobrevivência Celular/efeitos dos fármacos
9.
Anticancer Res ; 44(6): 2343-2348, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38821609

RESUMO

BACKGROUND/AIM: The standard treatment for localized prostate cancer involves surgical removal of the prostate with curative intent. However, when tumor cells persist in the operation site, there is high risk of local recurrence and tumor spread, leading to stressful follow-up treatments, impaired quality of life, and reduced overall survival. This study examined photoimmunotherapy (PIT) as a new treatment option for prostate cancer cells. MATERIALS AND METHODS: We generated conjugates consisting of either a humanized antibody or Fab fragments thereof targeting the prostate specific membrane antigen (PSMA), along with our silicon phthalocyanine photosensitizer dye WB692-CB1. PSMA-expressing prostate cancer cells were incubated with the antibody dye or Fab dye conjugates and cell binding was measured using flow cytometry. Cells were irradiated with varying doses of red light for dye activation, and cytotoxicity was determined by erythrosin B staining and subsequent analysis using a Neubauer counting chamber. RESULTS: Specific cytotoxicity was induced with the antibody dye conjugate in the prostate cancer cells in a light dose-dependent manner. Treatment of the cells with the Fab dye conjugate resulted in lower cytotoxicity, which could be attributed to a reduced binding affinity and a reduced dye uptake of the Fab fragment. CONCLUSION: Our new antibody dye and Fab dye conjugates offer potential for future intraoperative PIT in patients with localized prostate cancer, with the aim to ensure complete removal of tumor cells from the surgical area, to avoid local recurrence, and to improve clinical outcome.


Assuntos
Antígenos de Superfície , Fragmentos Fab das Imunoglobulinas , Imunoterapia , Neoplasias da Próstata , Humanos , Masculino , Fragmentos Fab das Imunoglobulinas/imunologia , Fragmentos Fab das Imunoglobulinas/química , Fragmentos Fab das Imunoglobulinas/farmacologia , Neoplasias da Próstata/terapia , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/patologia , Imunoterapia/métodos , Linhagem Celular Tumoral , Antígenos de Superfície/imunologia , Antígenos de Superfície/metabolismo , Glutamato Carboxipeptidase II/imunologia , Glutamato Carboxipeptidase II/metabolismo , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Fototerapia/métodos , Anticorpos Monoclonais Humanizados/farmacologia , Anticorpos Monoclonais Humanizados/uso terapêutico
10.
Adv Neonatal Care ; 24(3): E40-E46, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38815281

RESUMO

BACKGROUND: The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for hyperbilirubinemia is considered a safe complementary treatment for infants that may increase number of defecations and decrease bilirubin levels. PURPOSE: This study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels in term infants receiving phototherapy. METHODS: The sample consisted of 43 term newborns (intervention group: 23; control group: 20) who received phototherapy in a university hospital between June 2019 and February 2021. Information and observation forms were used for data collection. The intervention group received 6 abdominal massages over 2 days, performed 3 times a day, 6 hours apart, and lasting 5 minutes each. RESULTS: Transcutaneous bilirubin levels and heart rate were significantly lower in the intervention group than in the control group at 48 hours (P = .015 and P = .033, respectively). Number of defecations was higher in the intervention group at 24 hours (P = .007) but there was no significant difference at 48 hours. The decrease in serum bilirubin between 24 and 48 hours was significantly greater in the intervention group (P = .005). IMPLICATION FOR PRACTICE AND RESEARCH: Abdominal massage was effective in reducing bilirubin levels and may increase the number of defecations. Providing massage training to the parents of infants who are discharged early could be a protective approach to prevent the rise in bilirubin levels.


Assuntos
Bilirrubina , Hiperbilirrubinemia Neonatal , Massagem , Fototerapia , Humanos , Massagem/métodos , Recém-Nascido , Bilirrubina/sangue , Fototerapia/métodos , Feminino , Masculino , Hiperbilirrubinemia Neonatal/terapia , Abdome
11.
Med Clin North Am ; 108(4): 641-653, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38816108

RESUMO

Atopic dermatitis (AD) is a common, chronic relapsing, and remitting inflammatory skin disease that is characterized by erythematous, scaly, and pruritic lesions often located over the flexural surfaces. Treatment goals of AD include the reduction of itching and burning, as well as the reduction of skin changes. Treatment of AD includes emollients and skin care, topical therapies including topical corticosteroids and steroid-sparing therapies, systemic therapies, and phototherapy.


Assuntos
Dermatite Atópica , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/terapia , Humanos , Emolientes/uso terapêutico , Emolientes/administração & dosagem , Fototerapia/métodos , Corticosteroides/uso terapêutico , Corticosteroides/administração & dosagem , Fármacos Dermatológicos/uso terapêutico , Fármacos Dermatológicos/administração & dosagem , Higiene da Pele/métodos
12.
BMC Cancer ; 24(1): 664, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822331

RESUMO

Recent studies have shown that blue light-emitting diode (LED) light has anti-tumor effects, suggesting the possibility of using visible light in cancer therapy. However, the effects of blue light irradiation on cells in the tumor microenvironment, including tumor-associated macrophages (TAMs), are unknown. Here, THP-1 cells were cultured in the conditioned medium (CM) of HCT-116 cells to prepare TAMs. TAMs were divided into LED-irradiated and control groups. Then, the effects of blue LED irradiation on TAM activation were examined. Expression levels of M2 macrophage markers CD163 and CD206 expression were significantly decreased in LED-irradiated TAMs compared with the control group. While control TAM-CM could induce HCT-116 cell migration, these effects were not observed in cells cultured in TAM-CM with LED irradiation. Vascular endothelial growth factor (VEGF) secretion was significantly suppressed in LED-exposed TAMs. PD-L1 expression was upregulated in HCT-116 cells cultured with TAM-CM but attenuated in cells cultured with LED-irradiated TAM-CM. In an in vivo model, protein expression levels of F4/80 and CD163, which are TAM markers, were reduced in the LED-exposed group. These results indicate that blue LED light may have an inhibitory effect on TAMs, as well as anti-tumor effects on colon cancer cells.


Assuntos
Neoplasias do Colo , Luz , Macrófagos Associados a Tumor , Humanos , Neoplasias do Colo/radioterapia , Neoplasias do Colo/patologia , Neoplasias do Colo/metabolismo , Macrófagos Associados a Tumor/metabolismo , Macrófagos Associados a Tumor/efeitos da radiação , Macrófagos Associados a Tumor/imunologia , Luz/efeitos adversos , Animais , Células HCT116 , Camundongos , Microambiente Tumoral/efeitos da radiação , Movimento Celular/efeitos da radiação , Meios de Cultivo Condicionados/farmacologia , Antígenos de Diferenciação Mielomonocítica/metabolismo , Antígenos CD/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptores de Superfície Celular/metabolismo , Macrófagos/metabolismo , Macrófagos/efeitos da radiação , Macrófagos/imunologia , Fototerapia/métodos , Ativação de Macrófagos/efeitos da radiação , Luz Azul
13.
Hosp Pediatr ; 14(6): 421-429, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38766712

RESUMO

OBJECTIVES: Pediatric direct admissions (DA) have multiple benefits including reduced emergency department (ED) volumes, greater patient and provider satisfaction, and decreased costs without compromising patient safety. We sought to compare resource utilization and outcomes between patients with a primary diagnosis of neonatal hyperbilirubinemia directly admitted with those admitted from the ED. METHODS: Single-center, retrospective study at a large, academic, free-standing children's hospital (2017-2021). Patients were between 24 hours and 14 days old with a gestational age of ≥35 weeks, admitted with a primary diagnosis of neonatal hyperbilirubinemia. Outcomes included length of stay (LOS), time to clinical care, resource utilization, NICU transfer, and 7-day readmission for phototherapy. RESULTS: A total of 1098 patients were included, with 276 (25.1%) ED admissions and 822 (74.9%) DAs. DAs experienced a shorter median time to bilirubin level collection (1.9 vs 2.1 hours, P = .003), received less intravenous fluids (8.9% vs 51.4%, P < .001), had less bilirubin levels collected (median of 3.0 vs 4.0, P < .001), received phototherapy sooner (median of 0.8 vs 4.2 hours, P < .001), and had a shorter LOS (median of 21 vs 23 hours, P = .002). One patient who was directly admitted required transfer to the NICU. No differences were observed in the 7-day readmission rates for phototherapy. CONCLUSIONS: Directly admitting patients for the management of neonatal hyperbilirubinemia is a preferred alternative to ED admission as our study demonstrated that DAs had a shorter time to clinical care, shorter LOS, and less unnecessary resource utilization with no difference in 7-day readmissions for phototherapy.


Assuntos
Serviço Hospitalar de Emergência , Hiperbilirrubinemia Neonatal , Tempo de Internação , Readmissão do Paciente , Humanos , Recém-Nascido , Estudos Retrospectivos , Hiperbilirrubinemia Neonatal/terapia , Masculino , Feminino , Serviço Hospitalar de Emergência/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Fototerapia/métodos , Admissão do Paciente/estatística & dados numéricos
14.
Cochrane Database Syst Rev ; 5: CD011060, 2024 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-38804265

RESUMO

BACKGROUND: The American Academy of Pediatrics and the Canadian Paediatric Society both advise that all newborns should undergo bilirubin screening before leaving the hospital, and this has become the standard practice in both countries. However, the US Preventive Task Force has found no strong evidence to suggest that this practice of universal screening for bilirubin reduces the occurrence of significant outcomes such as bilirubin-induced neurologic dysfunction or kernicterus. OBJECTIVES: To evaluate the effectiveness of transcutaneous screening compared to visual inspection for hyperbilirubinemia to prevent the readmission of newborns (infants greater than 35 weeks' gestation) for phototherapy. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, ICTRP, and ISRCTN in June 2023. We also searched conference proceedings, and the reference lists of included studies. SELECTION CRITERIA: We included randomized controlled trials (RCTs), quasi-randomized, cluster-randomized, or prospective cohort studies with control arm that evaluated the use of transcutaneous bilirubin (TcB) screening for hyperbilirubinemia in newborns before hospital discharge. DATA COLLECTION AND ANALYSIS: We used standard methodologic procedures expected by Cochrane. We evaluated treatment effects using a fixed-effect model with risk ratio (RR) and 95% confidence intervals (CI) for categorical data and mean, standard deviation (SD), and mean difference (MD) for continuous data. We used the GRADE approach to evaluate the certainty of evidence. MAIN RESULTS: We identified one RCT (1858 participants) that met our inclusion criteria. The study included 1858 African newborns at 35 weeks' gestation or greater who were receiving routine care at a well-baby nursery, and were randomly recruited prior to discharge to undergo TcB screening. The study had good methodologic quality. TcB screening versus visual assessment of hyperbilirubinemia in newborns: - may reduce readmission to the hospital for hyperbilirubinemia (RR 0.25, 95% CI 0.14 to 0.46; P < 0.0001; moderate-certainty evidence); - probably has little or no effect on the rate of exchange transfusion (RR 0.20, 95% CI 0.01 to 14.16; low-certainty evidence); - may increase the number of newborns who require phototherapy prior to discharge (RR 2.67, 95% CI 1.56 to 4.55; moderate-certainty evidence). - probably has little or no effect on the rate of acute bilirubin encephalopathy (RR 0.33, 95% CI 0.01 to 8.18; low-certainty evidence). The study did not evaluate or report cost of care. AUTHORS' CONCLUSIONS: Moderate-certainty evidence suggests that TcB screening may reduce readmission for hyperbilirubinemia compared to visual inspection. Low-certainty evidence also suggests that TcB screening probably has little or no effect on the rate of exchange transfusion compared to visual inspection. However, moderate-certainty evidence suggests that TcB screening may increase the number of newborns that require phototherapy before discharge compared to visual inspection. Low-certainty evidence suggests that TcB screening probably has little or no effect on the rate of acute bilirubin encephalopathy compared to visual inspection. Given that we have only identified one RCT, further studies are necessary to determine whether TcB screening can help to reduce readmission and complications related to neonatal hyperbilirubinemia. In settings with limited newborn follow-up after hospital discharge, identifying newborns at risk of severe hyperbilirubinemia before hospital discharge will be important to plan targeted follow-up of these infants.


Assuntos
Bilirrubina , Recém-Nascido Prematuro , Icterícia Neonatal , Triagem Neonatal , Readmissão do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Recém-Nascido , Bilirrubina/sangue , Icterícia Neonatal/diagnóstico , Icterícia Neonatal/terapia , Icterícia Neonatal/sangue , Triagem Neonatal/métodos , Readmissão do Paciente/estatística & dados numéricos , Viés , Hiperbilirrubinemia Neonatal/diagnóstico , Hiperbilirrubinemia Neonatal/terapia , Fototerapia , Nascimento a Termo
15.
Adv Exp Med Biol ; 1447: 191-207, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38724794

RESUMO

Atopic dermatitis has a substantial impact on sleep, appearance, psychological well-being, and other qualities of life. The visual appearance of lichenification, cheilitis, hyperpigmentation, ichthyosis, and erythema can be socially stigmatizing, and treatment of these symptoms is challenging. In managing pruritus in patients, practitioners should assess and document pruritus through questionnaires at each routine visit. Initially, practitioners should advise patients to employ nonpharmaceutical treatments such as emollients with wet wraps, elimination of triggers, changing scratching habits, and psychological interventions. If these methods of treatment are not successful or if the disease presentation is severe, pharmacological therapies should be employed. This chapter describes the therapeutic ladder for pruritus in atopic dermatitis and discusses each treatment modality in further detail for practitioners to advise their patients.First-line topical pharmaceutical agents include topical glucocorticoids and topical calcineurin inhibitors. Second-line topical agents include coal tar, menthol, capsaicin, or doxepin. After the use of topical agents has been exhausted, primary systemic agents can be applied. These include sedating antihistamines, nonsedating antihistamines, oral glucocorticoids, or cyclosporine A. Finally, neuromodulating or immunomodulating agents can be attempted, including SSRI/SNRIs, TCAs, immunosuppressants, neural modulators, and opioid receptor modulators. Outside of pharmacological treatments, phototherapy has been shown to provide a dramatic improvement of pruritus in atopic dermatitis and can be used at any stage of treatment including as a first-line agent.


Assuntos
Dermatite Atópica , Prurido , Humanos , Antipruriginosos/uso terapêutico , Inibidores de Calcineurina/uso terapêutico , Dermatite Atópica/terapia , Dermatite Atópica/complicações , Glucocorticoides/uso terapêutico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Fototerapia/métodos , Prurido/terapia , Prurido/etiologia , Prurido/fisiopatologia , Prurido/tratamento farmacológico
16.
Ann Med ; 56(1): 2354852, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38767238

RESUMO

BACKGROUND: Major depressive disorder (MDD) is a debilitating condition that affects more than 300 million people worldwide. Current treatments are based on a trial-and-error approach, and reliable biomarkers are needed for more informed and personalized treatment solutions. One of the potential biomarkers, gamma-frequency (30-80 Hz) brainwaves, are hypothesized to originate from the excitatory-inhibitory interaction between the pyramidal cells and interneurons. The imbalance between this interaction is described as a crucial pathological mechanism in neuropsychiatric conditions, including MDD, and the modulation of this pathological interaction has been investigated as a potential target. Previous studies attempted to induce gamma activity in the brain using rhythmic light and sound stimuli (GENUS - Gamma Entrainment Using Sensory stimuli) that resulted in neuroprotective effects in Alzheimer's disease (AD) patients and animal models. Here, we investigate the antidepressant, cognitive, and electrophysiological effects of the novel light therapy approach using 40 Hz masked flickering light for patients diagnosed with MDD. METHODS AND DESIGN: Sixty patients with a current diagnosis of a major depressive episode will be enrolled in a randomized, double-blinded, placebo-controlled trial. The active treatment group will receive 40 Hz masked flickering light stimulation while the control group will receive continuous light matched in color temperature and brightness. Patients in both groups will get daily light treatment in their own homes and will attend four follow-up visits to assess the symptoms of depression, including depression severity measured by Hamilton Depression Rating Scale (HAM-D17), cognitive function, quality of life and sleep, and electroencephalographic changes. The primary endpoint is the mean change from baseline to week 6 in depression severity (HAM-D6 subscale) between the groups.


Assuntos
Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/terapia , Método Duplo-Cego , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fototerapia/métodos , Resultado do Tratamento , Adulto Jovem , Ritmo Gama/fisiologia , Idoso , Eletroencefalografia/métodos , Adolescente
17.
Photobiomodul Photomed Laser Surg ; 42(5): 356-365, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38776546

RESUMO

Background: Nosocomial wound infection with Pseudomonas aeruginosa (PA) is a serious complication often responsible for the septic mortality of burn patients. Objective: High-intensity antimicrobial blue light (aBL) treatment may represent an alternative therapy for PA infections and will be investigated in this study. Methods: Antibacterial effects of a light-emitting diode array (450-460 nm; 300 mW/cm2; 15/30 min; 270/540 J/cm2) against PA were determined by suspension assay, biofilm assay, and a human skin wound model and compared with 15-min topically applied 3% citric acid (CA) and wound irrigation solution (Prontosan®; PRT). Results: aBL reduced the bacterial number [2.51-3.56 log10 colony-forming unit (CFU)/mL], whereas PRT or CA treatment achieved a 4.64 or 6.60 log10 CFU/mL reduction in suspension assays. aBL reduced biofilm formation by 60-66%. PRT or CA treatment showed reductions by 25% or 13%. Here, aBL reduced bacterial number in biofilms (1.30-1.64 log10 CFU), but to a lower extend than PRT (2.41 log10 CFU) or CA (2.48 log10 CFU). In the wound skin model, aBL (2.21-2.33 log10 CFU) showed a bacterial reduction of the same magnitude as PRT (2.26 log10 CFU) and CA (2.30 log10 CFU). Conclusions: aBL showed a significant antibacterial efficacy against PA and biofilm formation in a short time. However, a clinical application of aBL in wound therapy requires effective active skin cooling and eye protection, which in turn may limit clinical implementation.


Assuntos
Biofilmes , Infecções por Pseudomonas , Pseudomonas aeruginosa , Infecção dos Ferimentos , Humanos , Pseudomonas aeruginosa/efeitos da radiação , Biofilmes/efeitos da radiação , Infecções por Pseudomonas/terapia , Infecções por Pseudomonas/radioterapia , Infecção dos Ferimentos/terapia , Infecção dos Ferimentos/microbiologia , Fototerapia , Luz Azul
18.
BMC Gastroenterol ; 24(1): 179, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778264

RESUMO

BACKGROUND: Inflammatory bowel disease (IBD) affects over 3 million Americans and has a relapsing and remitting course with up to 30% of patients experiencing exacerbations each year despite the availability of immune targeted therapies. An urgent need exists to develop adjunctive treatment approaches to better manage IBD symptoms and disease activity. Circadian disruption is associated with increased disease activity and may be an important modifiable treatment target for IBD. Morning light treatment, which advances and stabilizes circadian timing, may have the potential to improve IBD symptoms and disease activity, but no studies have explored these potential therapeutic benefits in IBD. Therefore, in this study, we aim to test the effectiveness of morning light treatment for patients with IBD. METHODS: We will recruit sixty-eight individuals with biopsy-proven IBD and clinical symptoms and randomize them to 4-weeks of morning light treatment or 4-weeks of treatment as usual (TAU), with equivalent study contact. Patient-reported outcomes (IBD-related quality of life, mood, sleep), clinician-rated disease severity, and a biomarker of gastrointestinal inflammation (fecal calprotectin) will be assessed before and after treatment. Our primary objective will be to test the effect of morning light treatment versus TAU on IBD-related quality of life and our secondary objectives will be to test the effects on clinician-rated disease activity, depression, and sleep quality. We will also explore the effect of morning light treatment versus TAU on a biomarker of gastrointestinal inflammation (fecal calprotectin), and the potential moderating effects of steroid use, restless leg syndrome, and biological sex. DISCUSSION: Morning light treatment may be an acceptable, feasible, and effective adjunctive treatment for individuals with active IBD suffering from impaired health-related quality of life. TRIAL REGISTRATION: The study protocol was registered on ClinicalTrials.gov as NCT06094608 on October 23, 2023, before recruitment began on February 1, 2024.


Assuntos
Ritmo Circadiano , Doenças Inflamatórias Intestinais , Fototerapia , Qualidade de Vida , Humanos , Doenças Inflamatórias Intestinais/terapia , Fototerapia/métodos , Complexo Antígeno L1 Leucocitário/análise , Índice de Gravidade de Doença , Qualidade do Sono , Masculino , Medidas de Resultados Relatados pelo Paciente , Feminino , Adulto , Fezes/química , Biomarcadores , Resultado do Tratamento
19.
Nat Rev Clin Oncol ; 21(6): 449-467, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38693335

RESUMO

Novel strategies utilizing light in the second near-infrared region (NIR-II; 900-1,880 nm wavelengths) offer the potential to visualize and treat solid tumours with enhanced precision. Over the past few decades, numerous techniques leveraging NIR-II light have been developed with the aim of precisely eliminating tumours while maximally preserving organ function. During cancer surgery, NIR-II optical imaging enables the visualization of clinically occult lesions and surrounding vital structures with increased sensitivity and resolution, thereby enhancing surgical quality and improving patient prognosis. Furthermore, the use of NIR-II light promises to improve cancer phototherapy by enabling the selective delivery of increased therapeutic energy to tissues at greater depths. Initial clinical studies of NIR-II-based imaging and phototherapy have indicated impressive potential to decrease cancer recurrence, reduce complications and prolong survival. Despite the encouraging results achieved, clinical translation of innovative NIR-II techniques remains challenging and inefficient; multidisciplinary cooperation is necessary to bridge the gap between preclinical research and clinical practice, and thus accelerate the translation of technical advances into clinical benefits. In this Review, we summarize the available clinical data on NIR-II-based imaging and phototherapy, demonstrating the feasibility and utility of integrating these technologies into the treatment of cancer. We also introduce emerging NIR-II-based approaches with substantial potential to further enhance patient outcomes, while also highlighting the challenges associated with imminent clinical studies of these modalities.


Assuntos
Raios Infravermelhos , Neoplasias , Humanos , Neoplasias/terapia , Neoplasias/diagnóstico por imagem , Neoplasias/radioterapia , Raios Infravermelhos/uso terapêutico , Fototerapia/métodos , Imagem Óptica/métodos , Oncologia/métodos
20.
J Mater Chem B ; 12(21): 5024-5038, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38712810

RESUMO

Composite materials can take advantages of the functional benefits of multiple pure nanomaterials to a greater degree than single nanomaterials alone. The UCNPs-MoS2 composite is a nano-application platform that combines upconversion luminescence and photothermal properties. Upconversion nanoparticles (UCNPs) are inorganic nanomaterials with long-wavelength excitation and short-wavelength tunable emission capabilities, and are able to effectively convert near-infrared (NIR) light into visible light for increased photostability. However, UCNPs have a low capacity for absorbing visible light, whereas MoS2 shows better absorption in the ultraviolet and visible regions. By integrating the benefits of UCNPs and MoS2, UCNPs-MoS2 nanocomposites can convert NIR light with a higher depth of detection into visible light for application with MoS2 through fluorescence resonance energy transfer (FRET), which compensates for the issues of MoS2's low tissue penetration light-absorbing wavelengths and expands its potential biological applications. Therefore, starting from the construction of UCNPs-MoS2 nanoplatforms, herein, we review the research progress in biological applications, including biosensing, phototherapy, bioimaging, and targeted drug delivery. Additionally, the current challenges and future development trends of UCNPs-MoS2 nanocomposites for biological applications are also discussed.


Assuntos
Dissulfetos , Molibdênio , Nanocompostos , Molibdênio/química , Dissulfetos/química , Nanocompostos/química , Humanos , Técnicas Biossensoriais , Animais , Fototerapia/métodos , Sistemas de Liberação de Medicamentos
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