Phototherapy Treatment Research Articles

Is targeted UVB as effective as excimer light phototherapy in treatment of vitiligo?

Excimer light (EL) and targeted UVB (TUVB) devices have been used successfully in repigmenting vitiligo. To compare the repigmenting efficacy and safety of EL with TUVB device in vitiligo. The study was conducted retrospectively on patients of vitiligo who had received either EL (Group A) or TUVB (Group B) from year 2015 to 2020. Data pertaining to 40 such age and sex matched patients from each group was retrieved with almost similar sites of involvement. Only patients whose phototherapy sessions had been given twice weekly for minimum of 30 sessions or until 90%-100% repigmentation were included in the study. The study was retrospective in nature and the principles outlined in the Declaration of Helsinki were followed during the study. The primary endpoint compared between the two groups was the extent of repigmentation achieved on different sites of body and adverse effects from treatment. Secondary endpoints compared included total number of doses, cumulative dose needed for complete repigmentation and number of doses needed for onset of repigmentation. There were 82.6% responders in Group A and 76.3% in Group B who had achieved at least 50% repigmentation. Excellent response (75%-100% repigmentation) was achieved in 68.1% lesions in Group A and 46.4% lesions in Group B. Patients in Group A needed less number of doses (13.75 vs. 19.37) and less cumulative dose (6.14 vs. 7.69 J/cm2 ) to achieve complete or near complete repigmentation. Adverse effects were negligible in both groups. Targeted phototherapy with EL demonstrated better repigmenting efficacy than TUVB in vitiligo.

Improvement Initiative: End-Tidal Carbon Monoxide Measurement in Newborns Receiving Phototherapy

To determine, as part of our Utah Newborn Nursery Bilirubin Management Program, whether end-tidal carbon monoxide concentration (ETCOc) measurements in all newborns in our nursery receiving phototherapy were associated with outcomes related to the management of hyperbilirubinemia, including time (hours after birth) when phototherapy was initiated, total duration of phototherapy during the nursery stay, repeat phototherapy treatments, and hospital readmission for phototherapy. We performed a planned interim analysis of a component of our program in which we measured ETCOc noninvasively using CoSense on each newborn in our nursery receiving phototherapy and recorded specific outcomes related to phototherapy management. Of 1856 newborns admitted to our nursery in a 6-month period in 2020, 170 (9.8%) were treated with phototherapy. An ETCOc reading was successfully obtained in 145 of 151 attempts (96%). Higher ETCOc values were associated with earlier institution of phototherapy and longer duration of phototherapy. For every 1-ppm increase in ETCOc, phototherapy was started 9hours earlier (95% CI, 3.3-14.8; P=.002) and was administered for an additional 9.3hours (95% CI, 4.1-14.6; P<.001). Three newborns were readmitted to the hospital for intensive phototherapy; while in the nursery, all 3 had an elevated ETCOc (2.2, 2.6, and 2.9ppm). Our findings provide answers to questions raised in the 2004 American Academy of Pediatrics bilirubin guidelines. In our neonatal nursery, measuring ETCOc in all phototherapy recipients was feasible and safe, and the results were associated with multiple aspects of phototherapy management. Higher ETCOc values predicted earlier and longer phototherapy courses.

To Determine the Efficacy and Safety of Narrow Band UVB (NB-UVB) in Chronic Hand Eczema (CHE)

Aim: To d etermin e the safety and efficacy of narrow band ultravoilet B radiations in chronic hand eczema. Methods: 62 patients were enrolled from OPD of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore. They weregiven phototherapy treatment through NB UVB local chamber, t hrice weekly (on fixed days) for a total of 12 weeks or until clearance. Patients were followed up fortnightly for further 1 month and final assessment was done at the end of one month. Physician’s Global Assessment (PGA) Score was used to assess the sever ity of eczema affecting the hands. Results The data was collected from 62 patients with 0% dropout. There was only one patient who had improvement &lt;25%, 4(6.45%) had improvement 25 50%, 8(12.90%) had 51 75% improvement and 49(79.03%)cases had improvem ent &gt;75%. Minimal side effects were seen which included erythema, photosensitivity, itching and pain. Conclusion : NB UBV is a safe as well as effective treatment option for chronic eczema of hands. Keywords : Chronic Hand Eczema, Narrow Band UVB, Physician’s Global Assessment Score.

Efficacy of combination of localized closure, ethacridine lactate dressing, and phototherapy in treatment of severe extravasation injuries: A case series.

BACKGROUNDThe management of severe extravasation injuries is still controversial. Extravasation injuries can be treated in many ways. AIMTo present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy. METHODSIn this study, we evaluated the data of eight patients, including six from the Department of Burn, one (with colorectal carcinoma) from the Veteran Cadre Department, and one (with leukemia) from the Hematology Department. Of these, three patients were male and five were female. Age of the patients ranged from 10 mo to 72 years, including two children (10 and 19 mo of age). In this study, the infusion was stopped immediately when the extravasation was identified. The extravasation event was managed routinely using a blocking solution. A ring-shaped localized closure was performed using the blocking agents. Moreover, ethacridine lactate dressing and phototherapy were applied for 3-5 d. RESULTSIn this study, the drugs contained in the infusates were iodixanol, norepinephrine, alprostadil, amino acids, fat emulsion, cefoselis, cefoxitin, and potassium chloride + concentrated sodium chloride. All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed. CONCLUSIONThe treatment of severe extravasation injuries using a combination of localized closure, ethacridine lactate dressing, and phototherapy resulted in satisfactory outcomes in patients.

Seeing the Treatment of Psoriasis in a New Light: A Novel Medical Device Utilizing Localized Coal Tar and Narrowband UVB for Targeted Treatment of Plaque Psoriasis.

Given the high costs of systemic psoriasis therapies, studies have also shown that phototherapy achieves significant cost savings by replacing or delaying drug-based systemic treatment in patients with moderate to severe disease. However, this modality is often underutilized mainly due to the lack of phototherapy treatment centers across the country. Home phototherapy was designed to fill this treatment gap and allow patients to be treated with phototherapy despite living in areas that may not have a formal treatment facility. Inspired by the Goeckerman regimen, a preliminary pilot study showed that a novel, home phototherapy device utilizing a mobile phone-controlled L.E.D UVB light source and an occlusive hydrogel patch containing coal tar was superior to control as well as both NB-UVB alone and a coal tar dressing alone.Visit the Psoriasis Resource Center for more on this topic.

Direct antiglobulin test in the prediction of hyperbilirubinemia and predischarge bilirubin levels in infants with mother-infant blood type incompatibility

This research evaluated the association between the mother-infant blood type or rhesus (ABO or Rh) incompatibility, the pattern of neonatal jaundice, and serum bilirubin (TSB) values obtained prior to discharge from hospital of healthy born neonates with gestational age >34 weeks and birth weight >2000 g. We utilized a laboratory and neonatal database to identify the cord blood ABO/Rh and direct antiglobulin test (DAT) and TSB measured during hospitalization and re-admission with hyperbilirubinemia for phototherapy treatment. We used hour-specific TSB to analyze the TSB levels for ABO/Rh compatibility and isoimmunization using chi-square, analysis of variance, and regression models. Of the 901 infants studied, 158 (17.5%) had ABO/Rh incompatibility, including 27 with positive DAT. Hyperbilirubinemia was diagnosed in 33.3% DAT positive, 6.9% DAT negative, and 4.6% of infants with compatible blood types. Increased predischarge TSB was observed in DAT positive infants at 48-72 h of postnatal age (P < 0.001). After controlling for age at TSB testing and weight loss percentage, multiple regression analysis did not show any impact of ABO/Rh incompatibility and DAT results on the predischarge TSB levels. Blood type incompatibility increases the frequency of hyperbilirubinemia only in the DAT-positive infants. Irrespective of the isoimmunization status, it does not significantly affect the level of predischarge TSB.

Neonatal Jaundice in Preterm Infants with Bilirubin Encephalopathy

Introduction: The aim of this study is to clarify bilirubin parameters and its treatment in preterm infants with bilirubin encephalopathy (pBE). Methods: We asked the responders to an earlier nationwide Japanese survey on pBE to provide additional information. pBE was diagnosed based on the criteria used in the nationwide survey. We collected data on serum total bilirubin (TB), direct bilirubin (DB), albumin, and unbound bilirubin (UB) levels during the first 8 weeks of life, and on phototherapy and exchange transfusion treatments. Results: We obtained clinical data from 75 patients with pBE from 58 hospitals (response rate of 59%), who were born between 2002 and 2016. The average peak TB level was 12.6 mg/dL (215 μmol/L), and the average age at peak attainment was 19.7 days after birth. Albumin level was <2.5 g/dL in 44 patients, and the peak DB level was ≥2 mg/dL (34.2 μmol/L) in 20 patients. The average peak bilirubin/albumin (B/A) (mg/g) ratio was 3.8 (molar ratio of 0.475), and the average age at peak attainment was 18.6 days. The average peak UB level was 0.67 μg/dL (11.5 nmol/L). The median duration of phototherapy was 6 days, and the median day of the last session was 12. The peak TB level occurred after the last day of phototherapy in 30 of the 61 patients available for comparison. Conclusions: Most patients with pBE lacked marked elevations in serum TB levels and the B/A ratio, the peaks of which were sometimes delayed to >4 weeks after birth.

Integrated analysis of microbiota with bile acids for the phototherapy treatment of neonatal jaundice.

Infant jaundice is a common condition which results from a high concentration of serum bilirubin. Phototherapy is a widely used treatment for bilirubin clearance. We analyzed the effect of phototherapy on intestinal flora and metabolism of newborns. The aim was to assess the benefit of treatment for hyperbilirubinemia with phototherapy. Fifty-three jaundiced infants hospitalized at our neonatal intensive care unit were treated with phototherapy. Of them, 29 were prescribed antibiotics during the hospitalization. Fecal samples were collected before and 24 h and 48 h after phototherapy. The bacterial species and relative abundance were identified with Macrogene sequencing. The bile acids in feces were identified using liquid chromatography-mass spectroscopy (LC-MS). Differential microbial species/genera and secondary bile acids were found after phototherapy. There are significant differences in the changes of the microbial species/genera between infants who did not receive antibiotic treatment and those who were given antibiotic treatment. Secondary bile acids were also significantly altered. At the same time, the differential microbial species/genera and the differential secondary bile acids interacted with each other. This study identified several differential intestinal microbial species and secondary bile acids in fecal samples from infants with jaundice before and after phototherapy. Phototherapy can change the flora and its metabolism and its long-term impact needs further observation.

Out-of-pocket costs for patients with psoriasis in an outpatient dermatology referral service

BackgroundPsoriasis is a chronic disease that derives great costs to the health care system. In Colombia, due to deficiencies in this system, patients are more likely to incur in out-of-pocket expenses; money that has never been quantified in this country. ObjectivesTo quantify out-of-pocket expenses and to analyze their relation to patients' clinical and labor characteristics in a cohort of psoriatic patients. MethodsA single-center, cross-sectional study was performed, evaluating psoriasis patients. ResultsA total of 100 psoriasis patients were analyzed. We identified that patients with higher dermatology life quality index and in phototherapy treatment were the ones that had higher out-of-pocket costs (p = 0.006 and 0.005, respectively). We found no correlation between out-of-pocket costs and occupational status, psoriasis area severity index or other types of treatment. The largest amount of money was used to buy medications and bus transportation with a maximum up to 440.50 and 528.60 USD, respectively. Among the 100 participants the total expense was 11131.90 USD in a 6-month period. Study limitationsLack of measurement of the labor productivity and labor absenteeism secondary to sick leave. ConclusionOut-of-pocket costs are similar with what was shown in previous studies. We found statistically significant differences for the DLQI in comparison with out-of-pocket expenses, regardless of the PASI level. Phototherapy treatment also had statistically significant differences in relationship with out-of-pocket expenses, when compared to other treatments, because it requires higher expenses in transportation, copayments, and alimentation during appointment assistance.

A low-cost bilirubin measurement tool for neonatal jaundice monitoring at the point-of-care: a comparison of BiliDx with a standard laboratory bilirubinometer and transcutaneous bilirubinometer

BackgroundNeonatal jaundice, defined as an excess of bilirubin in blood at birth or shortly thereafter, has a disproportionately high impact in low-resource settings. Three quarters of deaths from jaundice occur in sub-Saharan Africa and south Asia. Jaundice is easily treated with blue light phototherapy; however, accurate, low-cost bilirubin monitoring is essential to guide effective phototherapy treatment in low-resource settings. To address this need, we developed BiliDx, a low-cost, portable reader that quantifies bilirubin concentration in a few drops of blood applied to a lateral flow card. BiliDx measures absorbance at three wavelengths: blue (bilirubin), amber (haemoglobin interference), and red (background) and can perform measurements in less than 5 mins at the point of care, without the need for a costly centrifuge or extensive training. Here, we compare the accuracy of BiliDx against a standard laboratory bilirubinometer and a transcutaneous bilirubinometer. MethodsThis study took place in two central hospitals in Malawi. We included samples from neonates being treated in neonatal wards and deemed to be at risk for jaundice or who were undergoing phototherapy. Guardians provided written informed consent. We measured bilirubin using three devices: BiliDx, a bilirubinometer (Reichert UNISTAT), and a transcutaneous bilirubinometer (Drager JM-105), with a total of 475 measurements per device. Training (149 measurements) and validation (326 measurements) sets were created by ordering the first measurement per patient from lowest to highest UNISTAT bilirubin; every third measurement was selected for the training set. The training set was used to fit a model that correlated bilirubin concentration to absorbances at three wavelengths. The validation set was used to make an unbiased evaluation of the accuracy of the model. FindingsWe enrolled 456 neonates between August 7 and December 12, 2019; 247 of 326 (75%) of BiliDx measurements in the validation set were within 2 mg/dL of UNISTAT measurements, compared with 44 of 281 (6%) of quantitative transcutaneous measurements. No adverse events occurred. InterpretationBiliDx can provide accurate bilirubin monitoring. BiliDx is more accurate than transcutaneous bilirubinometry, a technology often endorsed for its non-invasive, portable nature. Limitations include that only ten nurses used BiliDx and only central hospitals were included. Testing of the BiliDx device is ongoing; we aim to collect enough measurements >20 mg/dL to assess the accuracy of BiliDx over the intended bilirubin concentration range of 0–35 mg/dL. Future studies will evaluate usability among a larger group of nurses and hospital settings. FundingUSAID Saving Lives at Birth Award No. 7200AA18FA0016.

Most Proper Timing of Transcutaneous Bilirubin Measurement After Phototherapy Treatment in the Newborn Period

Background: There are limited data about the proper transcutaneous bilirubin measuring time to detect levels that are close to serum bilirubin levels after ending the phototherapy treatment. Objectives: To compare the transcutaneous bilirubin and total serum bilirubin levels, and to evaluate the reliability of transcutaneous bilirubin measurements after phototherapy treatment of newborns because of hyperbilirubinemia. Methods: The study included 105 late preterm and term newborns consisting of 56 females (53.3%) and 49 males (46.6%), with gestational age 350/7 - 416/7 weeks who were treated with phototherapy. A Bilicheck (M&amp;B-MBJ20) device was used for transcutaneous bilirubin measurements. The average of three measurements on the skin in the mid-sternal area were obtained. Correlations between transcutaneous bilirubin and venous bilirubin levels were evaluated 6 and 12 hours after phototherapy. Transcutaneous bilirubin measurements were performed simultaneously with blood collection or within a maximum ± 15 minutes time difference for total serum bilirubin. Results: The average phototherapy time was 10 ± 2 (range, 8 - 12) hours. The average difference between transcutaneous bilirubin and venous bilirubin levels post phototherapy was 2.61 mg/dL after 6 hours and 0.8 mg/dL after 12 hours. The hematocrit levels of the patients ranged between 40 - 66% with an average of 53% ± 4.8, the median level was 51%. Correlation coefficients according to hours after treatment were high for the 6th hour (r = 0.76) and very high for the 12th hour. Conclusions: Jaundice scanning with transcutaneous bilirubin measurements 6 - 12 hours after the end of phototherapy is reliable and may be helpful in preventing additional blood collection from the heel.

Effect of platelet-rich plasma on the outcome of mini-punch grafting procedure in localized stable vitiligo: Clinical evaluation and relation to lesional basic fibroblast growth factor.

Surgical methods are favorably used for treatment of stable vitiligo, and platelet-rich plasma (PRP) can be added to augment the effect. The additive value of PRP, however, remains elusive. Basic fibroblast growth factor (bFGF) is released from activated platelets with a capacity for stimulating melanocyte proliferation and migration. The treatment outcomes for the mini-punch grafting (MPG)/phototherapy treatment with and without PRP were assessed and the relation between bFGF and the obtained results were evaluated. Thirty-four vitiliginous patches, two per each patient with stable vitiligo, were enrolled in this intrapatient-controlled study and treated with autologous MPG and subsequent exposure to phototherapy with and without enhancement via PRP procedure at the time of the procedure, and monthly for the subsequent 3 months. Re-pigmentation assessment via vitiligo scores as well as measurement of lesional bFGF were done. PRP assistance to MPG/phototherapy treatment resulted in earlier re-pigmentation at week 8. However, this enhancement effect vanished at the study end (week 20) as ideal re-pigmentation (>75% re-pigmentation) was encountered in 10 patches (58.8%) treated with MPG/phototherapy modality, and in 12 patches (70.6%) treated with PRP-assisted method without significant difference between them. Lesional bFGF increased after both treatments with a higher expression with PRP assistance but without clinical reflection on the final outcome. PRP can speed the re-pigmentation response for MPG/phototherapy procedure without any significant effect on the final outcome.

Phototherapy for Psoriasis: New Research and Insights

The purpose of the review is to highlight some of the new findings on phototherapy treatment for psoriasis and present clinical pearls for the practitioner. Recent research has helped to further elucidate the molecular mechanisms of UV light in the treatment of psoriasis. New evidence regarding the combination of phototherapy with biologic agents and phototherapy’s effect on quality of life is also highlighted. Phototherapy remains an effective and viable option for patients seeking non-invasive and safe treatment of psoriasis. Further research is still needed to understand the exact immunological effects and molecular pathways regarding the response of the skin to UV light. Further research is also needed with combination treatment phototherapy and the newest biologic agents.

Concentrations of metalloproteinase-1 in patients with morphea treated with phototherapy: a preliminary study.

Morphea (localized scleroderma) is a rare, chronic, inflammatory connective tissue disease, characterized by immune system dysfunction, vasculopathy and skin fibrosis. One of the most effective treatments is phototherapy. Phototherapy has been found to be effective in treating localized scleroderma by inducing the expression of metalloproteinase-1. To compare the concentrations of metalloproteinase (MMP-1) before psoralen and ultraviolet A (PUVA) and ultraviolet A1 (UVA1) treatments in the serum of patients with morphea. The observational study was conducted in one research centre and included patients with generalised morphea who were treated with PUVA and UVA1 phototherapies. The mean age of all morphea patients included in the study was 55.7 years. The levels of MMP-1 were examined by ELISA (The Biorbyt Human MMP-1 ELISA - Enzyme-Linked Immunosorbent Assay). The study showed that patients treated with PUVA and UVA1 had an improvement based on clinical measures, resulting in a reduction of clinical score. However, we did not observe statistically significant differences in MMP-1 concentrations before and after treatment. Limitations: The study sample was relatively small. Further studies on a larger group of patients would be beneficial. Our data suggest that there is a possible correlation between MMP-1 concentrations and phototherapy. MMP-1 levels were found to be increased following phototherapy treatment, which may suggest a correlation with better response to treatment in patients with morphea. However, further research is needed.

Atualizações sobre fototerapia em neonatos a termo e pré-termo com icterícia não-hemolítica

A fototerapia é um procedimento pouco invasivo utilizado no tratamento da icterícia, uma manifestação clínica decorrente do aumento da concentração de bilirrubina sérica total (BST). Acomete a maior parte dos recém-nascidos (RN), especialmente os prematuros. Elencar os principais benefícios, consequências, e atualizações acerca da fototerapia para tratamento de neonatos com icterícia não-hemolítica nascidos a termo ou pré-termo tardio (com idade gestacional ≥ 35 semanas). Trata-se de uma revisão sistemática que vasculha a literatura com permutações dos seguintes descritores: jaundice; phototerapy; e newborn; considerando os idiomas português, inglês e espanhol, e a data das publicações a partir de 2015. Além disso, fez-se uso do operador booleano AND. As bases de dados consultadas foram: SciELO, Lilacs, PubMED, MedLine, periódicos CAPES e WorldWildScience. Dos 314 artigos encontrados, 36 se adequaram ao entendimento do tema abordado. A fototerapia é um processo fotocatalisador capaz de converter moléculas de bilirrubina em luminirrubina a partir da luz solar ou artificial. Essa nova substância será excretada com maior facilidade, de forma a evitar danos neurotóxicos. É considerada segura e eficiente, mesmo levando em conta características individuais e fatores de risco como prematuridade, genética, e perfil materno. Portanto, a fototerapia é merecidamente o padrão ouro para o tratamento da icterícia neonatal não-hemolítica, mas exige cautela em sua prescrição e aplicação, visto que há a possibilidade de efeitos colaterais de amplo espectro. Também se faz necessário infraestrutura e manejo adequado.

Prospective 3-month study on the efficacy of UV-free blue light in mild psoriasis vulgaris treatment.

IntroductionPsoriasis is one of the most common chronic skin diseases affecting up to 2% of the general population. In recent years, an important direction for the development of treatment for psoriasis has been the use of blue light emitted by LED lamps.AimTo evaluate the efficacy of blue-light emitting device in psoriasis vulgaris treatment.Material and methodsThe study involved 30 adults with a mild form of psoriasis vulgaris not previously receiving biological treatment and other forms of phototherapy. Participants of the study used a device emitting blue LED light for 3 months. Each participant received a device for use at home, with which he/she exposed 2 psoriatic lesions located on the limbs. Before and after the study, the severity of the disease was evaluated using PASI, DLQI and LPSI.ResultsDuring 3 months of the therapy, a statistically significant decrease in the mean LPSI (in both treated locations) and DLQI was noted (LPSI decrease from 5.25 ±1.82 to 1.98 ±1.74, p < 0.0001; DLQI from 7.36 ±5.59 before the study to 5.23 ±4.62 after the study.ConclusionsOur results confirm that phototherapy using blue LED light is both a safe and highly effective way to treat psoriasis.

Complex treatment of children with vascular head and neck malformations

The article analyzes the results of treatment of children affected with lesions of blood vessels of the head and neck. The research is aimed at developing and implementing minimally invasive techniques to treat such children. The study group comprised 4416 patients with hyperplasia of blood vessels (the so-called infantile and congenital hemangiomas) and 397 patients with blood vessel malformations, examined and treated from 1991 to 2020. The paper summarizes developed indications and the results of implementation of effective minimally invasive methods for the treatment of children with vascular lesions: radiofrequency thermal ablation and pulsed dye laser treatment of children with severe forms of arterio-venous malformation in their maxillofacial area and. The treatment is currently the golden standard that provides stable aesthetic results. The most optimal and preferred methods of vascular lesions treatment proved to be minimally invasive techniques that include: radiofrequency thermal ablation, interstitial laser coagulation, pulse phototherapy, sclerotherapy and systemic treatment of beta-blockers.

Sequence-Defined Nanotubes Assembled from IR780-Conjugated Peptoids for Chemophototherapy of Malignant Glioma.

Near-infrared (NIR) laser-induced phototherapy through NIR agents has demonstrated the great potential for cancer therapy. However, insufficient tumor killing due to the nonuniform heat or cytotoxic singlet oxygen (1O2) distribution over tumors from phototherapy results in tumor recurrence and inferior outcomes. To achieve high tumor killing efficacy, one of the solutions is to employ the combinational treatment of phototherapy with other modalities, especially with chemotherapeutic agents. In this paper, a simple and effective multimodal therapeutic system was designed via combining chemotherapy, photothermal therapy (PTT), and photodynamic therapy (PDT) to achieve the polytherapy of malignant glioma which is one of the most aggressive tumors in the brain. IR-780 (IR780) dye-labeled tube-forming peptoids (PepIR) were synthesized and self-assembled into crystalline nanotubes (PepIR nanotubes). These PepIR nanotubes showed an excellent efficacy for PDT/PTT because the IR780 photosensitizers were effectively packed and separated from each other within crystalline nanotubes by tuning IR780 density; thus, a self-quenching of these IR780 molecules was significantly reduced. Moreover, the efficient DOX loading achieved due to the nanotube large surface area contributed to an efficient and synergistic chemotherapy against glioma cells. Given the unique properties of peptoids and peptoid nanotubes, we believe that the developed multimodal DOX-loaded PepIR nanotubes in this work offer great promises for future glioma therapy in clinic.

Mathematical model for treatment of neonatal hyperbilirubinemia.

Based on the mechanism of neonatal hyperbilirubinemia treatment methods (light, exchange blood and drugs), three types of neonatal hyperbilirubinemia treatment mathematical models are established, and the expressions of the model solutions are given in this paper. By applying clinical test data and numerical approximation algorithm, the relevant parameters in the model can be estimated. According to the standards of "Expert Consensus", two treatment plans are designed, which are 1) the combined transfusion and phototherapy treatment plan and 2) the combined treatment plan of drugs, transfusion and phototherapy. The results of the program operation are numerically simulated and compared with the treatment data of clinical cases. It is found that the coincidence effect is important, which verified the rationality of the model. The model results can track and predict the changes of bilirubin levels in real-time, which provides a theoretical basis for the clinical design of treatment plans.

Association between type of phototherapy management and hospital and patient-related outcomes in neonates with non-haemolytic jaundice at an Australian community hospital.

To evaluate the associations between type of light-emitting diode phototherapy intervention and hospital and patient related outcomes in term neonates with non-haemolytic jaundice. A retrospective observational study in a community hospital within a disadvantaged area in Australia was conducted. Data was extracted from hospital systems and medical records regarding the use of three types of phototherapy surface-area exposure for term neonates ≤28 days with non-haemolytic neonatal jaundice. Associations between type of phototherapy management and length of stay (LOS), rate of serum bilirubin (SBR) decline and duration of phototherapy were estimated using the general linear mixed model or linear regression. Of 102 neonates diagnosed with non-haemolytic jaundice between 1 June 2016 and 31 August 2017, 82 were included in final analyses. Neonates treated for jaundice during their first (birth) admission had a median LOS of 118 h for single-sided and 125 h for maximal double-sided phototherapy. Differences by phototherapy type were not statistically significant (P= 0.06). SBR rate of decline increased as surface-area of phototherapy increased (P< 0.001) with the fastest decline seen in maximal double-sided phototherapy. Estimated duration of phototherapy did not vary by phototherapy type but did vary by age at initiation of phototherapy (P= 0.006), with 16 fewer hours of phototherapy if commenced at ≥72 to <96 h versus ≥24 to 48 h of age (difference -16.4h, 95% confidence interval -29.1 to -3.7h). LOS and phototherapy duration were not associated with phototherapy type. Older neonates with neonatal jaundice required shorter phototherapy duration. Double-sided phototherapy was associated with faster reduction in SBR.