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Daniel S. Seidman - One of the best experts on this subject based on the ideXlab platform.
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a new blue light emitting Phototherapy device a prospective randomized controlled study
The Journal of Pediatrics, 2000Co-Authors: Daniel S. Seidman, Jonathan Moise, Zivanit Ergaz, Arie LaorAbstract:Objective: To evaluate the efficacy of a new Phototherapy light source with a narrow luminous blue spectrum. The device, made with high-intensity gallium nitride light-emitting diodes (LEDs), was compared with conventional Phototherapy at similar light intensities. Setting: Two university-affiliated community hospitals in Jerusalem. Design: Prospective open randomized study. Participants: Sixty-nine jaundiced, but otherwise healthy, term infants who met the entry criteria for Phototherapy set by the American Academy of Pediatrics' Practice Parameter. Main outcome measures: The duration of Phototherapy and the rate of decrease in total serum bilirubin (TSB) concentration. Results: The mean TSB concentrations at initiation and termination of treatment did not differ between newborns receiving LED and those receiving conventional Phototherapy. The duration of Phototherapy and the rate of decrease in TSB concentration were not statistically different in the 2 groups. The average rate of decrease in TSB after adjustment by a linear regression analysis for confounding factors was −3.16 μmol/L/h (95% confidence limits −4.81, −1.51) in newborns receiving LED Phototherapy compared with −2.19 μmol/L/h (−3.99, −0.40) in those treated with conventional Phototherapy ( P Conclusions: The blue gallium nitride LED device is as effective as conventional Phototherapy and is readily accepted by nursing staff. Future LED Phototherapy devices can provide much higher irradiance, and thus greater efficacy, and offer a new highly versatile approach to the treatment of jaundice.
Steven R Feldman - One of the best experts on this subject based on the ideXlab platform.
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a novel ultraviolet b home Phototherapy system efficacy tolerability adherence and satisfaction
Dermatology Online Journal, 2019Co-Authors: Emily L Unrue, Abigail Cline, Alexandra Collins, Vu H Nguyen, Michelle T Pelle, Patrick Blake, Steven R FeldmanAbstract:Background: Phototherapy is effective in treating psoriasis and other skin conditions. However, clinic-based Phototherapy can be time-consuming, expensive, and inconvenient. Conventional home Phototherapy addresses many hurdles, but has other limitations.Objective: Assess the treatment efficacy, adherence, and satisfaction of a novel ultraviolet B home Phototherapy system.Methods: Eight patients with stable plaque psoriasis completed a multicenter, prospective, open label, interventional study using a home Phototherapy device designed to improve treatment control and adherence. Matched control and study lesions were assessed on each subject. A dosing protocol based on American Academy of Dermatology guidelines for narrowband UVB Phototherapy was managed by the Phototherapy system. Responsiveness to the treatment was measured using the Psoriasis Severity Index (PSI) at 10 weeks versus control. Patient satisfaction was graded on a five-star Likert scale.Results: At 10 weeks, all patients experienced improvement in the treated lesions, with a mean improvement of 57% in PSI (P<0.0001 compared to baseline and P<0.0002 compared to the control lesions). Patient treatment adherence was 96% and treatment satisfaction was 100% five-star rated. Control lesions did not significantly change in PSI over the 10-week period (P=0.1411).Conclusions: The home Phototherapy system provided a safe and effective means to manage plaque psoriasis.
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a review of targeted ultraviolet b Phototherapy for psoriasis
Journal of The American Academy of Dermatology, 2012Co-Authors: Tejaswi Mudigonda, Tushar S Dabade, Steven R FeldmanAbstract:Targeted ultraviolet (UV) B Phototherapy devices provide a practical means to treat localized psoriasis while sparing harmful effects to unaffected skin. The objective of this study was to characterize the efficacy and safety of targeted Phototherapy devices for psoriasis. We conducted a PubMed search for broadband UVB, narrowband UVB, and localized Phototherapy, and a Google search for handheld Phototherapy. The most common targeted Phototherapy devices were characterized as 308-nm excimer laser, 308-nm excimer nonlaser, or nonexcimer light subtypes. Nine clinical trials met inclusion criteria and all found targeted Phototherapy efficacious. In a nonexcimer light study, high doses cleared the most plaques. The 308-nm excimer laser had long-term clearance in 13 of 26 patients. The mean number of UVB treatments in all 9 studies and highest cumulative dose was less than those same parameters in nontargeted phototherapies. Common adverse effects included erythema, blisters, hyperpigmentation, erosion, mild burning, and itching. The predominant setting for excimer units is the office; however, the majority of nonexcimer light devices can also be used at home. Targeted Phototherapy should be considered among the treatment options for localized variants of psoriasis.
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adherence to acitretin and home narrowband ultraviolet b Phototherapy in patients with psoriasis
Journal of The American Academy of Dermatology, 2008Co-Authors: Brad A. Yentzer, Christopher B Yelverton, Daniel J Pearce, Fabian Camacho, Zaineb Makhzoumi, Adele R Clark, Ann Boles, Alan B Fleischer, Rajesh Balkrishnan, Steven R FeldmanAbstract:Background In the treatment of psoriasis, patient adherence to oral medications is poor and even worse for topical therapy. However, few data exist about adherence rates to home Phototherapy, adding to concerns about the appropriateness of home Phototherapy as a psoriasis treatment option. Objective We sought to assess adherence to both oral acitretin and home ultraviolet B Phototherapy for the treatment of psoriasis. Methods In all, 27 patients with moderate to severe psoriasis were treated with 10 to 25 mg of acitretin daily, combined with narrowband ultraviolet B, 3 times weekly at home, for 12 weeks. Adherence to acitretin was monitored by an electronic monitoring medication bottle cap, and to Phototherapy by a light-sensing data logger. Results Adherence data were collected on 22 patients for acitretin and 16 patients for adherence to ultraviolet B. Mean adherence to acitretin decreased steadily during the 12-week trial (slope −0.24), whereas mean adherence to home Phototherapy remained steady at 2 to 3 d/wk. Adherence was similar between patients who reported side effects and those who did not. Limitations Small sample size and lack of follow-up on some patients were limitations of this study. Conclusions Adherence rates to home Phototherapy were very good and higher than adherence rates for the oral medication. Side effects of treatment were well tolerated in this small group and did not affect use of the treatment. Home Phototherapy with acitretin may be an appropriate option for some patients with extensive psoriasis.
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the utility of a data logging device for measuring adherence to home Phototherapy
Photodermatology Photoimmunology and Photomedicine, 2006Co-Authors: Christopher B Yelverton, Rajesh Balkrishnan, Steven R FeldmanAbstract:Background: Treatment adherence to home Phototherapy is not well characterized. Purpose: To develop an accurate measure of home Phototherapy unit usage. Methods: We tested a commercially available data logger containing a photo-sensor on two home Phototherapy units. Results: The data logger accurately recorded actual usage and did not record stray light sources over the study period. Conclusion: A data logger can accurately capture usage patterns for a home Phototherapy unit. These devices could potentially be used in clinical trials to measure adherence to home Phototherapy treatment regimens.
Zivanit Ergaz - One of the best experts on this subject based on the ideXlab platform.
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a new blue light emitting Phototherapy device a prospective randomized controlled study
The Journal of Pediatrics, 2000Co-Authors: Daniel S. Seidman, Jonathan Moise, Zivanit Ergaz, Arie LaorAbstract:Objective: To evaluate the efficacy of a new Phototherapy light source with a narrow luminous blue spectrum. The device, made with high-intensity gallium nitride light-emitting diodes (LEDs), was compared with conventional Phototherapy at similar light intensities. Setting: Two university-affiliated community hospitals in Jerusalem. Design: Prospective open randomized study. Participants: Sixty-nine jaundiced, but otherwise healthy, term infants who met the entry criteria for Phototherapy set by the American Academy of Pediatrics' Practice Parameter. Main outcome measures: The duration of Phototherapy and the rate of decrease in total serum bilirubin (TSB) concentration. Results: The mean TSB concentrations at initiation and termination of treatment did not differ between newborns receiving LED and those receiving conventional Phototherapy. The duration of Phototherapy and the rate of decrease in TSB concentration were not statistically different in the 2 groups. The average rate of decrease in TSB after adjustment by a linear regression analysis for confounding factors was −3.16 μmol/L/h (95% confidence limits −4.81, −1.51) in newborns receiving LED Phototherapy compared with −2.19 μmol/L/h (−3.99, −0.40) in those treated with conventional Phototherapy ( P Conclusions: The blue gallium nitride LED device is as effective as conventional Phototherapy and is readily accepted by nursing staff. Future LED Phototherapy devices can provide much higher irradiance, and thus greater efficacy, and offer a new highly versatile approach to the treatment of jaundice.
Jonathan Moise - One of the best experts on this subject based on the ideXlab platform.
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a new blue light emitting Phototherapy device a prospective randomized controlled study
The Journal of Pediatrics, 2000Co-Authors: Daniel S. Seidman, Jonathan Moise, Zivanit Ergaz, Arie LaorAbstract:Objective: To evaluate the efficacy of a new Phototherapy light source with a narrow luminous blue spectrum. The device, made with high-intensity gallium nitride light-emitting diodes (LEDs), was compared with conventional Phototherapy at similar light intensities. Setting: Two university-affiliated community hospitals in Jerusalem. Design: Prospective open randomized study. Participants: Sixty-nine jaundiced, but otherwise healthy, term infants who met the entry criteria for Phototherapy set by the American Academy of Pediatrics' Practice Parameter. Main outcome measures: The duration of Phototherapy and the rate of decrease in total serum bilirubin (TSB) concentration. Results: The mean TSB concentrations at initiation and termination of treatment did not differ between newborns receiving LED and those receiving conventional Phototherapy. The duration of Phototherapy and the rate of decrease in TSB concentration were not statistically different in the 2 groups. The average rate of decrease in TSB after adjustment by a linear regression analysis for confounding factors was −3.16 μmol/L/h (95% confidence limits −4.81, −1.51) in newborns receiving LED Phototherapy compared with −2.19 μmol/L/h (−3.99, −0.40) in those treated with conventional Phototherapy ( P Conclusions: The blue gallium nitride LED device is as effective as conventional Phototherapy and is readily accepted by nursing staff. Future LED Phototherapy devices can provide much higher irradiance, and thus greater efficacy, and offer a new highly versatile approach to the treatment of jaundice.
R S Dawe - One of the best experts on this subject based on the ideXlab platform.
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self administration of hospital based narrowband ultraviolet b tl 01 Phototherapy a feasibility study in an outpatient setting
British Journal of Dermatology, 2013Co-Authors: S Yule, Harry Moseley, S Sanyal, S H Ibbotson, R S DaweAbstract:Summary Background Self-administration of narrowband (TL-01) ultraviolet (UV)B Phototherapy by patients at home is a safe and effective mode of treatment. Could selected patients self-administer Phototherapy in hospital? Objectives To assess the feasibility of outpatient self-administration of UVB Phototherapy as a potential service development. Methods A total of 20 patients with psoriasis (n = 15) and eczema (n = 5) (13 female, mean age 32 years, range 17–56 years) were included in this pilot project. Patients underwent a training programme over 2 days, which included a minimal erythemal dose test and supervised treatment, prior to commencing self-administration of Phototherapy. Questionnaires were used to gather feedback from patients and staff.
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taking treatment to the patient development of a home tl 01 ultraviolet b Phototherapy service
British Journal of Dermatology, 2002Co-Authors: H Cameron, S Yule, Harry Moseley, R S Dawe, J FergusonAbstract:SummaryBackground While most patients requiring Phototherapy can attend for hospital-based out-patient ultraviolet (UV) B therapy, a significant number cannot attend because of geographical, work, economic and other reasons. Objectives To determine whether there was a need for home Phototherapy in the Tayside area and, if so, to establish protocols and then to assess if such a service would be workable. Methods Patients referred from dermatology out-patient clinics in Tayside for narrow-band UVB (TL-01) Phototherapy completed a pilot questionnaire that was followed by a two-phase project. In phase 1, patients with psoriasis were trained to use the home Phototherapy equipment (HoPE) within the hospital department under nursing supervision while a teaching package and protocols were developed. In phase 2, home Phototherapy was made available for patient use in the community, supported by a specialist home Phototherapy nurse. Waldmann UV100 home therapy units were used, with accurate dosimetry. Detailed treatment records were kept and questionnaires were used to assess acceptability and costs of therapy. Results Fifty-two pilot questionnaires were completed. Forty-two per cent of respondents found hospital Phototherapy inconvenient and 75% felt Phototherapy at home would be helpful. In phase 1, seven of 10 patients trained to use the HoPE completed therapy with the HoPE unit alone, reaching minimal residual activity (MRA) or clearance in a median of 18 exposures (median dose 10·38 J cm−2). In phase 2, 32 courses of home Phototherapy were given to 30 patients. Of 23 with psoriasis, 18 reached clearance or MRA in a median of 22·5 exposures (median dose 9·84 J cm−2). Although self-reported erythema rates appeared higher than expected, all post-treatment questionnaire respondents would choose home Phototherapy over hospital therapy if required in the future. Conclusions UVB (TL-01) home Phototherapy is a useful practical development that has fulfilled a need in our catchment area. Where appropriate training and support teams are available it appears to be similar in effectiveness to hospital therapy, to be safe and to be cost-effective for patients.
