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Phototherapy

Phototherapy (phototherapy) is the use of artificially obtained infrared, visible and ultraviolet radiation for therapeutic purposes. In case of phototherapy, the natural radiation of the Sun is also used (see. Heliotherapy). The effect of light energy on the human body is determined by the intensity (lamp power and distance to the irradiated surface), the duration of exposure and the depth of penetration of electromagnetic waves. The depth of penetration of light energy is different: the greatest in the field of red and infrared and the smallest in ultraviolet rays.

When exposed to the skin, light rays cause redness - erythema. Under the action of infrared rays, erythema appears during or several minutes after irradiation (thermal erythema). Under the action of ultraviolet rays, erythema appears after a certain (2-8 hours) latent (hidden) period (photoelectric erythema). The degree of skin reaction depends on the dose and the sensitivity of the skin to ultraviolet rays. The latter is not the same in different parts of the body (regional photosensitivity) and decreases from the skin of the chest, abdomen, back to the skin of the hands and the yogi. Repeated exposures lower sensitivity, therefore in the fall it is lower than in spring.

Skin reactivity may be altered in some pathological conditions: enhanced with certain forms of eczema , some neurovascular lesions, increased thyroid function , while taking a number of drugs (sulfa drugs), weakened with chronic infectious diseases accompanied by general exhaustion, in seriously injured, changed in lesions of various parts of the nervous system. After 3-4 days, pigmentation (tanning) appears at the site of irradiation, which is possible without prior formation of erythema, as a result of repeated long-wave ultraviolet irradiation, especially solar, or artificial. The intensity of pigmentation depends on the course of the pathological process.

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The mechanism of action of ultraviolet radiation - see. Ultraviolet radiation . The action of visible and especially infrared radiation (see) is accompanied by expansion of blood and lymphatic vessels, increased blood and lymph circulation, increased metabolism and tissue temperature.

For the purpose of therapeutic and prophylactic effects on the body, artificial light sources are used, which, depending on the methods of radiation, are divided into caloric and luminescent. In caloric (thermal) sources, the amount and composition of the emitted energy depends on the degree of heating of the radiating body. These include incandescent lamps emitting infrared and visible rays (see Solux-lamp , Minina lamp).

Luminescent light sources are caused by electrical, chemical phenomena. This category of sources includes mercury-quartz lamps, bactericidal and erythemal UV-V lamps (see UV irradiators ).

Indications . Visible and infrared rays are used as an analgesic and absorbing agent, mainly for subacute and chronic inflammatory processes, neuralgic and muscular pains, as well as to enhance the metabolic processes in the body. Ultraviolet rays are used for general exposures in the case of ultraviolet deficiency , to strengthen the body, increase resistance to various infections (see Fotarii ); in erythemal dosages - as an analgesic and anti-inflammatory agent in the treatment of some forms of arthritis, diseases of the peripheral nervous system (neuritis, neuralgia, radiculitis ), muscular (myositis), respiratory (bronchitis, pleurisy) systems, and skin and gynecological diseases. Ultraviolet irradiation of varying intensity and localization is used in metabolic disorders, joint tuberculosis, bones, lymphatic glands, peritonitis of tuberculosis etiology , fibrosis of pulmonary tuberculosis. Desensitizing effect of ultraviolet irradiation is used in the treatment of arthritis of allergic origin, bronchial asthma (in the interictal period), with a tendency to catarrhal diseases, bronchitis, laryngitis and others. , radiculitis .

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In order to disinfect the air, shortwave ultraviolet radiation is used in children's and medical institutions, in operating rooms, dressings.

Contraindications . The use of light, in particular, ultraviolet rays, is contraindicated in the active form of pulmonary tuberculosis, malignant neoplasms, cardiac, renal failure , hypertension of II - III degree, severe depletion, increased thyroid function, and in case of increased sensitivity ( sensitization ) to light.

Phototherapy in pediatrics . The anatomical and physiological characteristics of the child’s body determine its hypersensitivity to light therapy.

The most caution requires ultraviolet irradiation; before their use, it is necessary to determine biodoze (see) Severe "threshold" erythema in young children often appears when irradiated for 15 seconds. General ultraviolet irradiation is prescribed to premature babies with gradually increasing doses from 1/2 to 2 biodoses with simultaneous heating with a solux or infra-ray lamp. General ultraviolet radiation is prescribed for rickets , for the prevention of catarrh of the upper respiratory tract, as well as in the interictal period of rheumatism to increase the body's defenses. Local ultraviolet irradiation is prescribed for chronic tonsillitis (tonsil irradiation). As a result of general ultraviolet radiation in prophylactic doses, an improvement in appetite, sleep, and physical development indicators is observed.

Contraindications to the use of ultraviolet radiation are the same as for adults, and, in addition, increased excitability of the central nervous system.