Abstract Title: Hyperbaric oxygen reduces inflammation, oxygenates injured muscle, and regenerates skeletal muscle via macrophage and satellite cell activation. Abstract Source: Sci Rep. 2018 Jan 22 ;8(1):1288. Epub 2018 Jan 22. PMID: 29358697 Abstract Author(s): Takuya Oyaizu, Mitsuhiro Enomoto, Naoki Yamamoto, Kunikazu Tsuji, Masaki Horie, Takeshi Muneta, Ichiro Sekiya, Atsushi Okawa, Kazuyoshi Yagishita Article Affiliation: Takuya Oyaizu Abstract: Hyperbaric oxygen treatment (HBO) promotes rapid recovery from soft tissue injuries. However, the healing mechanism is unclear. Here we assessed the effects of HBO on contused calf muscles in a rat skeletal muscle injury model. An experimental HBO chamber was developed and rats were treated with 100% oxygen, 2.5 atmospheres absolute for 2 h/day after injury. HBO reduced early lower limb volume and muscle wet weight in contused muscles, and promoted muscle isometric strength 7 days after injury. HBO suppressed the elevation of circulating macrophages in the acute phase and then accelerated macrophage invasion into the contused muscle. This environment also increased the number of proliferating and differentiating satellite cells and the amount of regenerated muscle fibers. In the early phase after injury, HBO stimulated the IL-6/STAT3 pathway in contused muscles. Our results demonstrate that HBO has a dual role in decreasinginflammation and accelerating myogenesis in muscle contusion injuries.

Abstract Title: Hyperbaric Oxygen Attenuates Withdrawal Symptoms by Regulating Monoaminergic Neurotransmitters and NO Signaling Pathway at Nucleus Accumbens in Morphine-Dependent Rats. Abstract Source: Neurochem Res. 2018 Jan 8. Epub 2018 Jan 8. PMID: 29313212 Abstract Author(s): Chunxia Chen, Qiuping Fan, Zhihuan Nong, Wan Chen, Yaoxuan Li, Luying Huang, Daorong Feng, Xiaorong Pan, Shengyong Lan Article Affiliation: Chunxia Chen Abstract: In this study, we examined whether hyperbaric oxygen (HBO2) plays a detoxification role in withdrawal symptoms in a morphine-dependent rat model. The model was established through injections of morphine at increasing doses for 7 days. Withdrawal symptoms were induced by naloxone injection on the 8th day. The detoxification effect of HBO2 was evaluated using the withdrawal symptom scores, biochemical indices and neurotransmitters. Compared with the model group, HBO2 therapy significantly attenuated the withdrawal symptom scores, body weight loss and the level of norepinephrine level, whereas it increased the dopamine level and tyrosine hydroxylase expression in the nucleus accumbens. Moreover, HBO2 therapy substantially alleviated the NO, NOS, cAMP, and cGMP levels. Our findings indicate that HBO2 can effectively alleviate withdrawal symptoms induced by morphine dependence, and these effects may be attributed to the modulation of monoaminergic neurotransmitters and the suppression of the NO-cGMP signaling pathway. Article Published Date : Jan 07, 2018

Abstract Title: Efficacy of hyperbaric oxygen therapy in bacterial biofilm eradication. Abstract Source: J Wound Care. 2018 Jan 1 ;27(Sup1):S20-S28. PMID: 29334015 Abstract Author(s): Nicholas E Sanford, Jeremy E Wilkinson, Hao Nguyen, Gabe Diaz, Randall Wolcott Article Affiliation: Nicholas E Sanford Abstract: OBJECTIVE: Chronic wounds typically require several concurrent therapies, such as debridement, pressure offloading, and systemic and/or topical antibiotics. The aim of this study was to examine the efficacy of hyperbaric oxygen therapy (HBOT) towards reducing or eliminating bacterial biofilms in vitro and in vivo. METHOD: Efficacy was determined using in vitro grown biofilms subjected directly to HBOT for 30, 60 and 90 minutes, followed by cell viability determination using propidium monoazide-polymerase chain reaction (PMA-PCR). The efficacy of HBOT in vivo was studied by searching our chronic patient wound database and comparing time-to-healing between patients who did and did not receive HBOT as part of their treatment. RESULTS: In vitro data showed small but significant decreases in cell viability at the 30- and 90-minute time points in the HBOT group. The in vivo data showed reductions in bacterial load for patients who underwent HBOT, and ~1 week shorter treatment durations. Additionally, in patients' chronic wounds there was a considerable emergence of anaerobic bacteria and fungi between intermittent HBOT treatments. CONCLUSION: The data demonstrate that HBOT does possess a certain degree of biofilm killing capability. Moreover, as an adjuvant to standard treatment, more favourable patient outcomes are achieved through a quicker time-to-healing which reduces the chance of complications. Furthermore, the data provided insights into biofilm adaptations to challenges presented by this treatment strategy which should be kept in mind when treating chronic wounds. Further studies will be necessary to evaluate the benefits and mechanisms of HBOT, not only for patients with chronic wounds but other chronic infections caused by bacterial biofilms. Article Published Date : Dec 31, 2017

Abstract Title: Hyperbaric oxygen protects against myocardial reperfusion injury via the inhibition of inflammation and the modulation of autophagy. Abstract Source: Oncotarget. 2017 Dec 19 ;8(67):111522-111534. Epub 2017 Dec 4. PMID: 29340072 Abstract Author(s): Chunxia Chen, Wan Chen, Yaoxuan Li, Yanling Dong, Xiaoming Teng, Zhihuan Nong, Xiaorong Pan, Liwen Lv, Ying Gao, Guangwei Wu Article Affiliation: Chunxia Chen Abstract: Our previous study demonstrated that hyperbaric oxygen (HBO) preconditioning protected against myocardial ischemia reperfusion injury (MIRI) and improved myocardial infarction. However, HBO's effect on MIRI-induced inflammation and autophagy remains unclear. In this study, we investigate the potential impact and underlying mechanism of HBO preconditioning on an MIRI-induced inflammatory response and autophagy using a ligation of the left anterior descending (LAD) coronary artery rat model. Our results showed that HBO restored myocardial enzyme levels and decreased the apoptosis of cardiomyocytes, which were induced by MIRI. Moreover, HBO significantly suppressed MIRI-induced inflammatory cytokines. This effect was associated with the inhibition of the TLR4-nuclear factor kappa-B (NF-κB) pathway. Interestingly, lower expression levels of microtubule-associated protein 1 light chain 3B (LC3B) and Beclin-1 were observed in the HBO-treatment group. Furthermore, we observed that HBO reduced excessive autophagy by activating the mammalian target of the rapamycin (mTOR) pathway, as evidenced by higher expression levels of threonine protein kinase (Akt) and phosphorylated-mTOR. In conclusion, HBO protected cardiomocytes during MIRI by attenuating inflammation and autophagy. Our results provide a new mechanistic insight into the cardioprotective role of HBO against MIRI. Article Published Date : Dec 18, 2017

Abstract Title: Hyperbaric oxygen attenuates neuropathic pain and reverses inflammatory signaling likely via the Kindlin-1/Wnt-10a signaling pathway in the chronic pain injury model in rats. Abstract Source: J Headache Pain. 2017 Dec ;18(1):1. Epub 2017 Jan 5. PMID: 28058534 Abstract Author(s): Baisong Zhao, Yongying Pan, Haiping Xu, Xingrong Song Article Affiliation: Baisong Zhao Abstract: BACKGROUND: Hyperbaric oxygen (HBO) therapy is proven to attenuate neuropathic pain in rodents. The goal of the present study was to determine the potential involvement of the Kindlin-1/Wnt-10a signaling pathway during astrocyte activation and inflammation in a rodent model of neuropathic pain. METHODS: Rats were assigned into sham operation, chronic constriction injury (CCI), and CCI + HBO treatment groups. Neuropathic pain developed in rats following CCI of the sciatic nerve. Rats in the CCI + HBO group received HBO treatment for five consecutive days beginning on postoperative day 1. The mechanical withdrawal threshold (MWT) and the thermal withdrawal latency (TWL) tests were performed to determine mechanical and heat hypersensitivity of animals, respectively. Kindlin-1, Wnt-10a and β-catenin protein expression was examined by immunohistochemistry and Western blot analysis. Expression of tumor necrosis factor (TNF)-α was also determined by ELISA. RESULTS: Our findings demonstrated that HBO treatment significantly suppressed mechanical and thermal hypersensitivity in the CCI neuropathic pain model in rats. HBO therapy significantly reversed the up-regulation of Kindlin-1 in dorsal root ganglia (DRG), spinal cord, and hippocampus of CCI rats. CCI-induced astrocyte activation and increased levels of TNF-α were efficiently reversed by HBO (P < 0.05 vs. CCI). HBO also reversed Wnt-10a up-regulation induced by CCI in the DRG, spinal cord, and hippocampus (P < 0.05 vs. CCI). CONCLUSIONS: Our findings demonstrate that HBO attenuated CCI-induced rat neuropathic pain and inflammatory responses, possibly through regulation of the Kindlin-1/Wnt-10a signaling pathway. Article Published Date : Nov 30, 2017

Abstract Title: Hyperbaric Oxygen Therapy in the Treatment of Acute Severe Traumatic Brain Injury: a Systematic Review. Abstract Source: J Neurotrauma. 2017 Nov 13. Epub 2017 Nov 13. PMID: 29132229 Abstract Author(s): Samuel Daly, Maxwell Thorpe, Sarah B Rockswold, Molly Hubbard, Thomas A Bergman, Uzma Samadani, Gaylan Rockswold Article Affiliation: Samuel Daly Abstract: There has been no major advancement in a quarter of a century for the treatment of acute severe traumatic brain injury (TBI). This review summarizes 40 years of clinical and pre-clinical research on the treatment of acute TBI with hyperbaric oxygen therapy (HBO2) in the context of an impending National Institute of Neurologic Disorders and Stroke (NINDS)-funded, multicenter, randomized, adaptive Phase II clinical trial - the Hyperbaric Oxygen Brain Injury Treatment (HOBIT) trial. Thirty studies (8 clinical and 22 pre-clinical) that administered HBO2 within 30 days of a TBI were identified from PubMed searches. The pre-clinical studies consistently reported positive treatment effects across a variety of outcome measures with almost no safety concerns, thus providing strong proof-of-concept evidence for treating severe TBI in the acute setting. Of the 8 clinical studies reviewed, 4 were based on the senior author's (GR) investigation of HBO2 as a treatment for acute severe TBI. These studies provided evidence that HBO2 significantly improves physiologic measures without causing cerebral or pulmonary toxicity and can potentially improve clinical outcome. These results were consistent across the other 4 reviewed clinical studies, thus providing preliminary clinical data supporting the HOBIT trial. This comprehensive review demonstrates that HBO2 has the potential to be the first significant treatment in the acute phase of severe TBI. Article Published Date : Nov 12, 2017

Abstract Title: A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study. Abstract Source: J Wound Care. 2017 Nov 2 ;26(11):692-695. PMID: 29131751 Abstract Author(s): P Aguiar, C Amaral, A Rodrigues, A H de Souza Article Affiliation: P Aguiar Abstract: This study reports on the case of an elderly patient, with diabetes, and a bullous wound on the left big toe that led to an amputation of the first and second left toes. The amputation was because of deep injury as it was not able to heal with a conventional treatment. After completing the normal treatment and the removal of a bacterial infection in the lesion, the patient underwent a treatment that was based on a hydrogel gel (0.9% saline solution) and hyperbaric oxygen therapy (HBOT). After 60 sessions of the therapy, almost complete closure of the wound was observed. There were no reports of discomfort or infection during the treatment. After seven months of treatment almost complete healing was observed with no infection. This treatment appears to be effective and should be recommended for the treatment of DFUs. Article Published Date : Nov 01, 2017

Abstract Title: Efficacy of alogliptin combined with motor imagery under hyperbaric oxygen in diabetic nephropathy with silent cerebral infarction. Abstract Source: Biomed Rep. 2017 Nov ;7(5):407-415. Epub 2017 Sep 14. PMID: 29181153 Abstract Author(s): Danyan Chen, Xiaolong Huang, Hua Gan, Xiaogang Du, Song Lu, Rongxi Huang, Ke Liu, Binghan Zhang Article Affiliation: Danyan Chen Abstract: In the present study, we evaluated the curative effect of dipeptidyl peptidase-IV (DPP-IV) inhibitor alogliptin combined with motor imagery under hyperbaric oxygen in diabetic nephropathy (DN) with silent cerebral infarction (SCI). Two-hundred newly diagnosed DN patients with and without SCI were included. The SCI patients were divided into two treatment groups: Alogliptin (A group, n=50) and alogliptin combined with motor imagery under hyperbaric oxygen (B group, n=50). The degrees of neurocognitive dysfunction were evaluated at baseline and after 6 months of treatment. Thromboelastograms (TEGs) mapping were conducted. Serum glycoprotein VI (GPVI) mRNA expression and urine 11-DH-TXB2 levels were determined. Compared to group A patients, the severity of neurofunctional defects, GPVI mRNA expression and 11-DH-TXB2 levels were significantly lower in group B (P<0.05), while comprehensive, MoCA scores were higher in group B. The MoCA subscores of visuospatial/executive function, attention and concentration were significantly higher compared to group A (P<0.05). The sub-scores of computation, abstract thinking, language competence, memory and orientation were also higher in group B but the differences were not significant (P>0.05). TEG indexes were improved in both groups after treatment as manifested by increased R and K values, but there was significant improvement in group B. Intra-group comparisons revealed a time-dependent effect of treatment. In conclusion, the treatment of alogliptin combined with motor imagery under hyperbaric oxygen can better promote thrombolysis absorption, restore brain damage and improve neurocognitive function in DN with silent cerebral infarction. Article Published Date : Oct 31, 2017

Abstract Title: Hyperbaric oxygen therapy ameliorates pathophysiology of 3xTg-AD mouse model by attenuating neuroinflammation. Abstract Source: Neurobiol Aging. 2017 Oct 20 ;62:105-119. Epub 2017 Oct 20. PMID: 29141186 Abstract Author(s): Ronit Shapira, Beka Solomon, Shai Efrati, Dan Frenkel, Uri Ashery Article Affiliation: Ronit Shapira Abstract: There is a real need for new interventions for Alzheimer's disease (AD). Hyperbaric oxygen therapy (HBOT), the medical administration of 100% oxygen at conditions greater than 1 atmosphere absolute, has been used successfully to treat several neurological conditions, but its effects on AD pathology have never been thoroughly examined. Therefore, we exposed old triple-transgenic (3xTg) and non-transgenic mice to HBOT followed by behavioral, histological, and biochemical analyses. HBOT attenuated neuroinflammatory processes by reducing astrogliosis, microgliosis, and the secretion of proinflammatory cytokines (IL-1β and TNFα) and increasing expression of scavenger receptor A, arginase1, and antiinflammatory cytokines (IL-4 and IL-10). Moreover, HBOT reduced hypoxia,amyloid burden, and tau phosphorylation in 3xTg mice and ameliorated their behavioral deficits. Therefore, we suggest that HBOT has multifaceted effects that reduce AD pathologies, even in old mice. Given that HBOT is used in the clinic to treat various indications, including neurological conditions, these results suggest HBOT as a novel therapeutic intervention for AD. Article Published Date : Oct 19, 2017

Abstract Title: Hyperbaric oxygen alleviates the activation of NLRP‑3‑inflammasomes in traumatic brain injury. Abstract Source: Mol Med Rep. 2017 Oct ;16(4):3922-3928. Epub 2017 Jul 24. PMID: 29067455 Abstract Author(s): Huihui Qian, Qinghe Li, Woda Shi Article Affiliation: Huihui Qian Abstract: Growing evidence has demonstrated that the nucleotide‑binding oligomerization domain‑like receptor family pyrin domain containing 3 (NLRP‑3) inflammasome‑mediated inflammatory pathways have been involved in the secondary injury of traumatic brain injury (TBI). In the present study, the authors investigated the effects of hyperbaric oxygen (HBO) therapy on the NLRP‑3 inflammasome pathway following TBI. Following the evaluation of motor deficits and brain edema, the therapeutic effects of HBO on interleukin (IL)‑1β and IL‑18 expression were assessed, as well as NLRP‑3 inflammasome activation following TBI. HBO may improve motor score and reduce brain edema, accompanied with the reduction of IL‑1β and IL‑18 during the 7‑day observation period. Furthermore, HBO suppressed mRNA and protein expression of NLRP‑3‑inflammasome components, especially reducing NLRP‑3 expression in microglia. Thus, these results suggestedthat HBO alleviates the inflammatory response in experimental TBI via modulating microglial NLRP‑3‑inflammasome signaling. Article Published Date : Sep 30, 2017

Abstract Title: Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers: A Randomized Controlled Trial. Abstract Source: J Wound Ostomy Continence Nurs. 2017 Sep 29. Epub 2017 Sep 29. PMID: 28968346 Abstract Author(s): Chen-Yu Chen, Re-Wen Wu, Mei-Chi Hsu, Ching-Jung Hsieh, Man-Chun Chou Article Affiliation: Chen-Yu Chen Abstract: PURPOSE: The purpose of this study was to compare the effect of standard wound care with adjunctive hyperbaric oxygen therapy (HBOT) to standard wound care alone on wound healing, markers of inflammation, glycemic control, amputation rate, survival rate of tissue, and health-related quality of life in patients with diabetic foot ulcers (DFUs). DESIGN: Prospective, randomized, open-label, controlled study. SUBJECTS AND SETTING: The sample comprised 38 patients with nonhealing DFUs who were deemed poor candidates for vascular surgery. Subjects were randomly allocated to an experimental group (standard care plus HBOT, n = 20) or a control group (standard care alone, n = 18). The study setting was a medical center in Kaohsiung City, Taiwan. METHODS: Hyperbaric oxygen therapy was administered in a hyperbaric chamber under 2.5 absolute atmospheric pressure for 120 minutes; subjects were treated 5 days a week for 4 consecutive weeks. Both groups received standard wound care including debridement of necrotic tissue, topical therapy for Wagner grade 2 DFUs, dietary control and pharmacotherapy to maintain optimal blood glucose levels. Wound physiological indices were measured and blood tests (eg, markers of inflammation) were undertaken. Health-related quality of life was measured using the Medical Outcomes Study 36-Item Short Form. RESULTS: Complete DFU closure was achieved in 5 patients (25%) in the HBOT group (n = 20) versus 1 participant (5.5%) in the routine care group (n = 18) (P = .001). The amputation rate was 5% for the HBOT group and 11% for the routine care group (χ = 15.204, P = .010). The HBOT group showed statistically significant improvements in inflammation index, blood flow, and health-related quality of life from pretreatment to 2 weeks after the last therapy ended (P<.05). Hemoglobin A1c was significantly lower in the HBOT group following treatment (P<.05) but not in the routine care group. CONCLUSIONS: Adjunctive HBOT improved wound healing in persons with DFU. Therapy also reduced the risk of amputation of the affected limb. We assert that at least 20 HBOT sessions are required to be effective. Article Published Date : Sep 28, 2017

Abstract Title: Hyperbaric oxygen promotes neural stem cell proliferation by activating vascular endothelial growth factor/extracellular signal-regulated kinase signaling after traumatic brain injury. Abstract Source: Neuroreport. 2017 Sep 25. Epub 2017 Sep 25. PMID: 28953090 Abstract Author(s): Yongkai Yang, Hao Wei, Xiaohui Zhou, Fan Zhang, Chunhua Wang Article Affiliation: Yongkai Yang Abstract: Hyperbaric oxygen (HBO) therapy and neural stem cell (NSC) transplantation can improve traumatic brain injury (TBI) clinically. This study aimed to investigate the mechanism of HBO promoting NSC proliferation and neurological recovery after TBI. Twenty-four Sprague-Dawley rats were divided randomly into three groups: a sham group, a TBI group (constructed using Feeney's free-fall method), and an HBO-treated TBI group. Neurological function was evaluated by Neurological Severity Scores on days 1, 3, and 7, and we found that TBI-induced poor neurological function was improved by HBO. On day 7 after TBI, we observed that TBI promoted NSC proliferation, migration to the lesion area, and the levels of vascular endothelial growth factor (VEGF), VEGFR2, Raf-1, MEK1/2, and phospho-extracellular signal-regulated kinase (ERK) 1/2 protein, which were further boosted by HBO, from immunohistochemistry, immunofluorescence, and Western blot experiments. In vitro, cell injury was applied to NSCs isolated from neonatal Sprague-Dawley rats by the Cell Injury Controller II system. Moreover, data from the BrdU Kit and Western blot showed that in-vitro HBO significantly accelerated NSC proliferation and the levels of proteins related to cell cycle and the VEGF/ERK pathway after cell injury, which was suppressed by the VEGFR2 inhibitor. Taken together, this study indicated that HBO may promote NSC proliferation by activating VEGF/ERK signaling and play a crucial role in neuroprotection after TBI. Article Published Date : Sep 24, 2017

Abstract Title: Hyperbaric oxygenation alleviates chronic constriction injury (CCI)-induced neuropathic pain and inhibits GABAergic neuron apoptosis in the spinal cord. Abstract Source: Scand J Pain. 2017 Sep 15. Epub 2017 Sep 15. PMID: 28927648 Abstract Author(s): Huiqun Fu, Fenghua Li, Sebastian Thomas, Zhongjin Yang Article Affiliation: Huiqun Fu Abstract: BACKGROUND AND AIMS: Dysfunction of GABAergic inhibitory controls contributes to the development of neuropathic pain. We examined our hypotheses that (1) chronic constriction injury (CCI)-induced neuropathic pain is associated with increased spinal GABAergic neuron apoptosis, and (2) hyperbaric oxygen therapy (HBO) alleviates CCI-induced neuropathic pain by inhibiting GABAergic neuron apoptosis. METHODS: Male rats were randomized into 3 groups: CCI, CCI+HBO and the control group (SHAM). Mechanical allodynia was tested daily following CCI procedure. HBO rats were treated at 2.4 atmospheres absolute (ATA) for 60min once per day. The rats were euthanized and the spinal cord harvested on day 8 and 14 post-CCI. Detection of GABAergic cells and apoptosis was performed. The percentages of double positive stained cells (NeuN/GABA), cleaved caspase-3 or Cytochrome C in total GABAergic cells or in total NeuN positive cells were calculated. RESULTS: HBO significantly alleviated mechanical allodynia. CCI-induced neuropathic pain was associated with significantly increased spinal apoptotic GABA-positive neurons. HBO considerably decreased these spinal apoptotic cells. Cytochrome-C-positive neurons and cleaved caspase-3-positive neurons were also significantly higher in CCI rats. HBO significantly decreased these positive cells. Caspase-3 mRNA was also significantly higher in CCI rats. HBO reduced mRNA expression of caspase-3. CONCLUSIONS: CCI-induced neuropathic pain was associated with increased apoptotic GABAergic neurons induced by activation of key proteins of mitochondrial apoptotic pathways in the dorsal horn of the spinal cord. HBO alleviated CCI-induced neuropathic pain and reduced GABAergic neuron apoptosis. The beneficial effect of HBO may be via its inhibitory role in CCI-induced GABAergic neuron apoptosis by suppressing mitochondrial apoptotic pathways in the spinal cord. IMPLICATIONS: Increased apoptotic GABAergic neurons induced by activation of key proteins of mitochondrial apoptotic pathways in the dorsal horn of the spinal cord is critical in CCI-induced neuropathic pain. The inhibitory role of HBO in GABAergic neuron apoptosis suppresses ongoing neuropathic pain. Article Published Date : Sep 14, 2017

Abstract Title: Acute kidney injury caused by decompression illness successfully treated with hyperbaric oxygen therapy and temporary dialysis. Abstract Source: CEN Case Rep. 2017 Sep 12. Epub 2017 Sep 12. PMID: 28900861 Abstract Author(s): Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama Article Affiliation: Arata Hibi Abstract: A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints. Hyperbaric oxygen therapy (HBOT) was immediately administered. His symptoms improved after the first course of HBOT, however, the patient had anuria for almost 36 h after admission and exhibited acute kidney injury (AKI). Serum creatinine and creatine kinase (CK) levels were increased to maximal values of 6.16 mg/dL and 18,963 U/L, respectively. Blood flow signals were not detected on kidney Doppler ultrasound. We considered that AKI was caused by blood flow impairment and capillary leak syndrome due to DCI in addition to rhabdomyolysis secondary to arterial gas embolism in the skeletal muscles. Temporary dialysis was required to correct the acidemia and electrolyte disturbance. Diuretic phase was initiated, and the patient was put off dialysis on day 3. Serum creatinine and CK levels returned to normal on day 11. He was successfully treated without any complications. Although AKI is a rare manifestation, we should consider AKI risk in patients with severe DCI. Article Published Date : Sep 11, 2017

Abstract Title: Hyperbaric oxygen sensitizes anoxic Pseudomonas aeruginosa biofilm to ciprofloxacin. Abstract Source: Antimicrob Agents Chemother. 2017 Sep 5. Epub 2017 Sep 5. PMID: 28874373 Abstract Author(s): Mette Kolpen, Christian J Lerche, Kasper N Kragh, Thomas Sams, Klaus Koren, Anna S Jensen, Laura Line, Thomas Bjarnsholt, Oana Ciofu, Claus Moser, Michael Kühl, Niels Høiby, PeterØ Jensen Article Affiliation: Mette Kolpen Abstract: Chronic Pseudomonas aeruginosa lung infection is characterized by the presence of endobronchial antibiotic-tolerant biofilm subject to strong oxygen (O2) depletion due to the activity of surrounding polymorphonuclear leukocytes. The exact mechanisms affecting the antibiotic susceptibility of biofilms remain unclear, but accumulating evidence suggests that the efficacy of several bactericidal antibiotics is enhanced by stimulation of aerobic respiration of pathogens, while lack of O2 increases their tolerance. In fact, the bactericidal effect of several antibiotics depends on active aerobic metabolism activity and the endogenous formation of reactive O2 radicals (ROS). In this study we aimed to apply hyperbaric oxygen treatment (HBOT) in order to sensitize anoxic P. aeruginosa agarose-biofilms established to mimic situations with intense O2 consumption by the host response in the cystic fibrosis (CF) lung. Application of HBOT resulted in enhanced bactericidal activity of ciprofloxacin at clinically relevant durations and was accompanied by indications of restored aerobic respiration, involvement of endogenous lethal oxidative stress and increased bacterial growth. The findings highlight that oxygenation by HBOT improves the bactericidal activity of ciprofloxacin on P. aeruginosa biofilm and suggest that bacterial biofilms is sensitized to antibiotics by supplying hyperbaric O2. Article Published Date : Sep 04, 2017

Abstract Title: Hyperbaric oxygen in patients with ischemic stroke following cardiac surgery: a retrospective observational trial. Abstract Source: Undersea Hyperb Med. 2017 Sept-Oct;44(5):377-385. PMID: 29116691 Abstract Author(s): Viktoria Heide-Marie Weixler, Ameli Elisabeth Yates, Markus Puchinger, Birgit Zirngast, Prisca Pondorfer, Beatrice Ratzenhofer-Komenda, Andrea Amegah-Sakotnik, Freyja-Maria Smolle-Juettner, Otto Dapunt Article Affiliation: Viktoria Heide-Marie Weixler Abstract: BACKGROUND: Hyperbaric oxygenation (HBO₂) involves breathing 100% oxygen under elevated ambient pressure in a hyperbaric chamber, thereby dissolving oxygen in the plasma. This results in an increase of arterial partial pressure of oxygen (pO₂). Though well established in experimental studies, HBO₂ treatment for ischemic stroke is still under discussion. METHODS: From 2002-2014 HBO₂ (2.2 bar, 90 minutes one/day; average number per patient: 4.7) was applied in 49 consecutive patients (32 males, 17 females, mean age: 68.8 years, range 31.2 - 83.9) with acute neurological deficit following cardiac surgery (CABG 15; combined surgery 14; valve surgery 11; aneurysm repair 8; malformation 1). Patients' history including TIA or stroke and carotid artery pathology were documented. Both degree and type of neurological deficit was evaluated by a scoring system (0-4) before and after HBO₂ treatment. RESULTS: Before HBO₂ therapy, the average motor deficit score was 2.45 and the average speech disorder score was 0.55, as compared with an average motor deficit of 1.12 and an average speech disorder of 0.27 afterward (α=0.0001, α=0.009). The majority of patients had an overall improvement of 2 score-points afterHBO₂ therapy (n=23 patients). Probit analysis showed that for a 50% response/probability (LC50) of having an overall outcome of ≥2 scoring points, an estimate of 4.3 HBO₂ therapy sessions is necessary. CONCLUSIONS: HBO2₂ therapy was associated with significant improvement in patients with acute neurological deficits due to ischemic stroke following cardiac surgery. Though this fact suggests gas embolism as the most likely cause of stroke in this collective, other underlying pathologies cannot be ruled out. Randomized studies are needed for further evaluation.

Abstract Title: Hyperbaric oxygen protects type II collagen in interleukin-1β-induced mandibular condylar chondrocyte via inhibiting the JNK/c-Jun signaling pathway. Abstract Source: Oncotarget. 2017 Sep 1 ;8(36):60312-60323. Epub 2017 Jul 17. PMID: 28947973 Abstract Author(s): Qi Sun, Gaoyi Wu, Hang Chen, Lei Chen, Hongyu Chen, Guoxiong Zhu, Huaqiang Zhao Article Affiliation: Qi Sun Abstract: The aim of this study was to explore the mechanisms of Hyperbaric oxygen (HBO) protective on interleukin-1β (IL-1β) induced rat's mandibular condylar chondrocytes. Chondrocytes were exposure to Hyperbaric oxygen after induced inflammatory by IL-1β. After that, the expression of p-JNK and c-Jun was increased significantly, while the Sox-9 was decreased significantly, Immunofluorescence results showedthat the expression of p-JNK and p-c-Jun were decreased while the expression of Sox-9 and COL2 were increased in chondrocytes treated with IL-1β and selective JNK inhibitor. Hyperbaric oxygen might plays similar roles with the JNK-specific inhibitor SP600125, inducing the increase of Sox-9 and COL2expression. On the whole, IL-1β induced inflammatory in chondrocytes by activating the JNK/c-Jun signaling pathway and down-regulate the expression of Sox-9 and COL2. However, Hyperbaric oxygen can inhibits IL-1β induced inflammatory response in chondrocytes though block the JNK/c-Jun signaling pathway and up-regulate the expression of Sox-9 and COL2. Article Published Date : Aug 31, 2017

Abstract Title: Hyperbaric Oxygen Therapy after Acute Thoracic Spinal Cord Injury: Improvement of Locomotor Recovery in Rats. Abstract Source: Spine (Phila Pa 1976). 2017 Aug 23. Epub 2017 Aug 23. PMID: 28837532 Abstract Author(s): Asdrubal Falavigna, Manuela Peletti Figueiró, Pedro Guarise da Silva, Lucas Piccoli Conzatti, Elisa Braun Rizkalla, Scheila Cardoso Dos Santos, Francine Würzius de Quadros, Lucas Radaelli Article Affiliation: Asdrubal Falavigna Abstract: STUDY DESIGN: controlled laboratory study. OBJECTIVE: analyse the effectiveness of HT using mild and moderate models of SCI. SUMMARY OF BACKGROUND DATA: Spinal Cord Injury (SCI) can cause permanent impairment with socioeconomic consequences. The motor deficit occurs by two mechanisms: destruction of neuronal cells and local inflammatory response, resulting in hypoxia. Hyperbaric Therapy (HT) acts by increasing oxygen in the injured area. METHODS: thoracic laminectomy was performed in 72 female Wistar rats. The MASCIS impactor was used at 12.5 mm (n = 35) and 25 mm (n = 35) of height to perform, respectively, mild and moderate SCI. Muscle strength was assessed through the Basso, Beattie and Bresnahan scale (BBB) on days 1, 7, 14, 21 and 28 after SCI. The animals were randomized into 5 subgroups with seven animals each: (1) control group had SCI without HT; (2) HT 30 minutes after SCI; (3) HT 30 minutes after SCI and daily for 7 days; (4) HT 12 hours after SCI; and (5) HT 12 hours after SCI and daily for 7 days. HT was performed at 2.5 atm for one hour. RESULTS: there was a linear relationship between injury severity and motor deficit until day 21, with similar BBB scores on day 28. A pattern of uniform lesions was observed in the mild SCI, with lower variation of BBB when compared to moderate SCI. All animals that underwent HT had significant improvement in motor function and histology when compared to control group. Regardless of the injury model, animals submitted to 7-day protocols had an early improvement in motor function and a smaller area of histological injury. CONCLUSIONS: the present study reported that the sooner HT is begun after mild and moderate SCI and the larger the number of sessions, the greater and earlier is the motor recovery and smaller is the tissue injury. LEVEL OF EVIDENCE: N/A. Article Published Date : Aug 22, 2017

Abstract Title: Oxygen therapies and their effects on wound healing. Abstract Source: Wound Repair Regen. 2017 Aug 7. Epub 2017 Aug 7. PMID: 28783878 Abstract Author(s): Gijs H J de Smet, Leonard F Kroese, Anand G Menon, Johannes Jeekel, Antoon W J van Pelt, Gert-Jan Kleinrensink, Johan F Lange Article Affiliation: Gijs H J de Smet Abstract: Oxygen is an important factor for wound healing. Although several different therapies investigated the use of oxygen to aid wound healing, the results of these studies are not unequivocal. This systematic review summarizes the clinical and experimental studies regarding different oxygen therapies for promoting wound healing, and evaluates the outcomes according the methodological details. A systematic literature search was conducted using Embase, Medline, Web of Science, Cochrane, PubMed publisher, and Google Scholar libraries. Clinical and experimental studies investigating oxygen for wound healing were selected. Included articles were categorized according to the kind of therapy, study design, and wound type. The methodological details were extracted and analyzed. Sixty-five articles were identified and divided in three different oxygen therapies: Local oxygen therapy, hyperbaric oxygen therapy, and supplemental inspired oxygen therapy. More than half of the included local oxygen and hyperbaric oxygen studies had one or more significant positive outcomes, 77 and 63%, respectively. Supplemental inspired oxygen therapy during gastrointestinal and vascular surgery was more likely to have a positive result than during other surgical interventions reducing surgical site infections. These many positive outcomes promote the use of oxygen treatment in the stimulation of wound healing. However, the lack of clinical studies and vast methodological diversity made it impossible to perform a proper comparison within and between the different therapies. Further randomized clinical studies are warranted to examine the value of these therapies, especially studies that investigate the more patient-friendly oxygen dressings and topical wound oxygen therapies. Also, to achieve more solid and consistent data, studies should use more standardized methods and subjects. Article Published Date : Aug 06, 2017

Abstract Title: Hyperbaric Oxygen Therapy for Wound Dehiscence After Intraoral Bone Grafting in the Nonirradiated Patient: A Case Series. Abstract Source: J Oral Maxillofac Surg. 2017 Jul 15. Epub 2017 Jul 15. PMID: 28784587 Abstract Author(s): M H J Hollander, O Boonstra, N M Timmenga, J Schortinghuis Article Affiliation: M H J Hollander Abstract: PURPOSE: In maxillofacial surgery, hyperbaric oxygen treatment is used almost exclusively as adjunctive therapy for osteoradionecrosis of the mandible in irradiated patients. It also is used to prevent the occurrence of osteoradionecrosis in the irradiated patient when dental surgery is indicated. Theoretically, hyperbaric oxygen therapy should benefit the nonirradiated patient in maxillofacial surgery (eg, patients with persistent intraoral wound dehiscences after bone grafting). MATERIALS AND METHODS: Six nonirradiated patients underwent hyperbaric oxygen therapy because of compromised wound healing after intraoral bone grafting of the maxilla as a preimplant procedure. All patients were treated 7 to 26 times with hyperbaric oxygen therapy at 2.5 ATA. RESULTS: All patients healed uneventfully. In retrospect, almost all patients had a history of chronic maxillary sinusitis or trauma to the operated area. CONCLUSION: Hyperbaric oxygen therapy seems to be an effective adjunctive therapy in the treatment of nonirradiated patients with compromised intraoral maxillary bone graft healing. Chronic maxillary sinus problems or a history of trauma could predispose to wound dehiscence after bone grafting. Article Published Date : Jul 14, 2017

Abstract Title: Delayed treatment of frostbite with hyperbaric oxygen: a report of two cases. Abstract Source: Undersea Hyperb Med. 2017 Jul-Aug;44(4):365-369. PMID: 28783893 Abstract Author(s): Corine A Lansdorp, Gert R Roukema, Onno Boonstra, Jan Dokter Article Affiliation: Corine A Lansdorp Abstract: Frostbite is an injury caused by the freezing of tissue, causing varied levels of tissue damage and necrosis. Case reports have shown a positive effect of hyperbaric oxygen (HBO₂) in such injuries, in acute cases as well as delayed (up to 21 days) presentation with complications. In this case report we present the course of hyperbaric treatment of two patients (a brother and sister, age 58 and 62) who sustained frostbite injuries to both feet 28 days earlier while hikingin the Himalayas. They were initially treated in Nepal following local protocol; afterward their primary care in the Netherlands was managed by the Burn Centre at Maasstad Hospital in Rotterdam. Both patients were treated with daily sessions of in total 80 minutes of 100% oxygen at 2.5 atmospheresabsolute. The female patient (age 62) received 25 sessions and showed a remarkable preservation of tissue and quick demarcation. Only partial surgical amputation of the second toe on the right was needed. In the male patient (age 58) both front feet were already mummified to a larger extent before start of treatment. During hyperbaric oxygen therapy 30 sessions) demarcation progressed quickly, resulting in early surgical amputation. Both patients experienced no side effects of HBO₂ treatment. Given that both patients showed a quick progress and demarcation of their wounds, with remarkable tissue preservation in the female patient, we suggest that hyperbaric oxygen therapy should be considered in treating frostbite injuries, in acute as well as delayed cases, even four weeks after initial injury. Article Published Date : Jun 30, 2017

Abstract Title: Attenuation of collagen-induced arthritis by hyperbaric oxygen therapy through altering immune balance in favor of regulatory T cells. Abstract Source: Undersea Hyperb Med. 2017 Jul-Aug;44(4):321-330. PMID: 28783888 Abstract Author(s): Byung-In Moon, Hyung-Ran Kim, Eun-Jeong Choi, Jeong-Hae Kie, Ju-Young Seoh Article Affiliation: Byung-In Moon Abstract: Hyperbaric oxygen (HBO₂) therapy is currently used for the treatment of chronic wounds, radiation-induced soft tissue necrosis, several oxygen-deficiency conditions and decompression sickness. In addition to the current indications, much empirical and experimental data suggest that HBO₂ therapy may benefit autoimmunediseases by suppressing immunity, but the underlying mechanism is not well understood. Therefore, in the present study, we investigated whether HBO₂ prevents the development of collagen-induced arthritis (CIA) in association with alteration of the immune balance between pro-inflammatory Th17 andanti-inflammatory regulatory T cells (Tregs). Arthritis was induced in DBA/1 mice by intradermal injection of type II collagen. Animals received either no treatment or 90 minutes of HBO₂ (100% oxygen, at 2.0 ATA) daily beginning three days prior to the injection and were monitored for the development of arthritis. Six weeks later, joint tissues and spleens were analyzed for the alteration of immune balance between Th17 and Tregs by immunohistochemistry (IHC) or Western blot. Injection of collagen-induced extensive arthritis and extramedullary hematopoiesis in the spleens. Meanwhile, joint swelling and inflammatory tissue damages as well as extramedullary hematopoiesis were significantly less severe in the mice treated with HBO₂. Both IHC and Western blot showed a decrease of FOXP3 and an increase of pSTAT3 expressions in the joints and spleens of the mice injected with collagen. Thissuggested that the systemic immune balance was biased toward Th17 cells, which was reversed by HBO₂ therapy. These results suggested acute CIA associated with an immune balance favoring Th17 was attenuated by HBO₂ in parallel with restoration of the immune balance to favor Tregs. Article Published Date : Jun 30, 2017

Abstract Title: Case control study: hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder. Abstract Source: Med Gas Res. 2017 Jul-Sep;7(3):156-174. Epub 2017 Oct 17. PMID: 29152209 Abstract Author(s): Paul G Harch, Susan R Andrews, Edward F Fogarty, Juliette Lucarini, Keith W Van Meter Article Affiliation: Paul G Harch Abstract: Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18-65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied. The measures included symptom lists, physical exam, neuropsychological and psychological testing on 29 subjects (1 dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due to the HBOT: reversible middle ear barotrauma (n = 6), transient deterioration in symptoms (n = 7), reversible bronchospasm (n = 1), and increased anxiety (n = 2; not related to confinement); unrelated to HBOT: ureterolithiasis (n = 1), chest pain (n = 2). Significant improvement (29 subjects) was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD, depression (including reduction in suicidal ideation), and reduced psychoactive medication usage. At 6-month follow-up subjects reported further symptomatic improvement. Compared to Controls the subjects' SPECT was significantly abnormal, significantly improved after 1 and 40 treatments, and became statistically indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be safe and significantly effective for veterans with mild to moderate TBI PPCS with PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, and SPECT imaging. Veterans also experienced a significant reduction in suicidal ideation and reduction in psychoactive medication use. Article Published Date : Jun 30, 2017

Abstract Title: Reduction of side effects of hyperbaric oxygen therapy with thymoquinone treatment in rats. Abstract Source: Undersea Hyperb Med. 2017 Jul-Aug;44(4):337-343. PMID: 28783890 Abstract Author(s): Ali Erdal Gunes, Orhan Gozeneli, Muhammed Emin Guldur Article Affiliation: Ali Erdal Gunes Abstract: INTRODUCTION: Hyperbaric oxygen (HBO₂) treatment results in elevated production of reactive oxygen species (ROS) that leads to cellular damage. Thymoquinone (TQ) is reported to have anti-inflammatory and antimicrobial activity and may suppress the generation of free radicals. The goal of this study is reduction of side effects of hyperbaric oxygen therapy with thymoquinone treatment. METHODS: 30 female Sprague-Dawley rats were randomly assigned to one of three groups (n = 10 per group). Group 1 represented the control group (no treatment). Group 2 was exposed to 100% oxygen at 2.5 ATA for two sessions of two hours'duration each day for five days. Group 3 was treated identically to Group 2 and was also given thymoquinone once daily at 50 mg/kg/day by oral gavage for five days, after first session of HBO₂. RESULTS: LOOH and SH levels were significantly elevated in the group receiving HBO₂ treatment relative to the control group rats. Fetuin A is increased during TQ treatment. LOOH and SH levels were significantly decreased in animals treated with TQ. CONCLUSIONS: Long-term and repeated HBO₂ treatment leads to damage to the lung tissue. In urgent situations or cases of severe hypoxia, repeated HBO₂ sessions may be necessary, and TQ antioxidant agents may be useful for prevention of HBO₂-associated injury. TQ may represent a useful therapeutic option during HBO₂ treatment. Article Published Date : Jun 30, 2017

Abstract Title: The Role of Hyperbaric Oxygen Therapy in Orthopedics and Rheumatological Diseases. Abstract Source: Isr Med Assoc J. 2017 Jul ;19(7):429-434. PMID: 28786258 Abstract Author(s): Giuseppe Barilaro, Ignazio Francesco Masala, Renato Parracchini, Cesare Iesu, Giulia Caddia, Piercarlo Sarzi-Puttini, Fabiola Atzeni Article Affiliation: Giuseppe Barilaro Abstract: Hyperbaric oxygen therapy (HBOT) has been investigated as a primary/adjunctive treatment for a number of injuries and medical conditions including traumatic ischemia, necrotizing soft tissue injuries, non-healing ulcers and osteoradionecrosis, but the results are controversial. There is insufficient evidence to support or reject the use of HBOT to quicken healing or to treat the established non-union of fractures. However, in patients with fibromyalgia, HBOT reduces brain activity in the posterior cortex and increases it in the frontal, cingulate, medial temporal and cerebellar cortices, thus leading to beneficial changes in brain areas that are known to function abnormally. Moreover, the amelioration of pain induced by HBOT significantly decreases the consumption of analgesic medications. In addition, HBOT has anti-inflammatory and oxygenatory effects in patients with primary or secondary vasculitis. This review analyzes the efficacy and limitations of HBOT in orthopedic and rheumatologic patients. Article Published Date : Jun 30, 2017

Abstract Title: Increased circulating stem cells and better cognitive performance in traumatic brain injury subjects following hyperbaric oxygen therapy. Abstract Source: Undersea Hyperb Med. 2017 May-Jun;44(3):257-269. PMID: 28779582 Abstract Author(s): Sabrina Shandley, E George Wolf, Christine M Schubert-Kappan, Laura M Baugh, Michael F Richards, Jennifer Prye, Helen M Arizpe, John Kalns Article Affiliation: Sabrina Shandley Abstract: Traumatic brain injury (TBI) may cause persistent cognitive dysfunction. A pilot clinical study was performed to determine if hyperbaric oxygen (HBO₂) treatment improves cognitive performance. It was hypothesized that stem cells, mobilized by HBO₂ treatment, are recruited to repair damaged neuronal tissue. This hypothesis was tested by measuring the relative abundance of stem cells in peripheral blood and cognitive performance during this clinical trial. The subject population consisted of 28 subjects with persistent cognitive impairment caused by mild to moderate TBI suffered during military deployment to Iraq or Afghanistan. Fluorescence-activated cell sorting (FACS) analysis was performed for stem cell markers in peripheral blood and correlated with variables resulting from standard tests of cognitive performance and post-traumatic stress disorder: ImPACT, BrainCheckers and PCL-M test results. HBO₂ treatment correlated with stem cell mobilization as well as increased cognitive performance. Together these results support thehypothesis that stem cell mobilization may be required for cognitive improvement in this population. Article Published Date : Apr 30, 2017

Abstract Title: Effects of hyperbaric oxygen therapy on open tibial fractures in rabbits after transient seawater immersion. Abstract Source: Undersea Hyperb Med. 2017 May-Jun;44(3):235-242. PMID: 28779580 Abstract Author(s): Xiaosong Chen, Xunsheng Cheng, Wuxiu Ma, Congcong Chen Article Affiliation: Xiaosong Chen Abstract: OBJECTIVE: To explore the effect and mechanism of hyperbaric oxygen (HBO₂) therapy of open tibial fractures in rabbits after transient seawater immersion. METHODS: Forty-eight (48) New Zealand rabbits were randomly and averagely divided into an HBO₂ therapy group (Group A) and a control group (Group B). All rabbits were subjected to unilateral open tibial fractures, while immersed in artificial seawater (20-22 °C) for three hours prior to debridement and external fixation. Group A was treated with HBO₂ at 2 atmospheres absolute (ATA) for50 minutes once daily for two weeks; Group B received postoperative routine treatments only. The fracture zone in each group was compared by radiological, histological and immunohistochemical examinations. RESULTS: In Group A, bony callus and mature osteocytes without infiltration of inflammatory cells were observed in the fracture zone. Vascular endothelial growth factor (VEGF) was expressed mainly in the cytoplasm of osteoblasts, chondrocytes and osteocytes, and exhibited significant changes at different time points. The gray value of bony callus in Group A was 190.58± 7.52; that of Group B was 144 ± 8.11. Difference between the groups was statistically significant (P ⟨ 0.01). The content of malondialdehyde (MDA) in Group A was significantly lower than Group B (P ⟨ 0.01), and the activity of superoxide dismutase (SOD) in Group A was higher than Group B (P⟨ 0.01) at four weeks. There were no significant differences in MDA content and SOD activity between groups at eight and 12 weeks. CONCLUSIONS: HBO₂ treatment of open tibial fractures in seawater can reduce the inflammatory reaction and reperfusion injury, and promote osteocytic proliferation and fracture healing. Article Published Date : Apr 30, 2017

Abstract Title: Hyperbaric Oxygen as Radiation Sensitizer for Locally Advanced Squamous Cell Carcinoma of the Oropharynx: A Phase 1 Dose-Escalation Study. Abstract Source: Int J Radiat Oncol Biol Phys. 2017 Mar 1 ;97(3):481-486. Epub 2016 Nov 15. PMID: 28126298 Abstract Author(s): Alan C Hartford, Thomas H Davis, Jay C Buckey, Robert L Foote, Mark S Sinesi, Benjamin B Williams, Anna K Fariss, Philip E Schaner, Paul L Claus, Scott H Okuno, James R Hussey, Richard E Clarke Article Affiliation: Alan C Hartford Abstract: PURPOSE: To explore, in a dose-escalation study, the feasibility of hyperbaric oxygen (HBO) treatments immediately before intensity modulated radiation therapy in conjunction with cisplatinum chemotherapy for squamous cell carcinoma of the head and neck (SCCHN). METHODS AND MATERIALS: Eligible patients presented with SCCHN (stage III-IV [M0]), life expectancy>6 months, and Karnofsky performance status ≥70. Enrollees received intensity modulated radiation therapy, 70 Gy in 35 fractions over 7 weeks with weekly cisplatinum. Patients received HBO-100% oxygen, 2.4 atmospheres absolute (ATA) for 30 minutes-twice per week initially. Subsequent patients were escalated to 3 and then 5 times per week. Intensity modulated radiation therapy began within 15 minutes after HBO. Patients were followed for 2 years after RT with quality-of-life questionnaires (Performance Status Scale-Head and Neck Cancer and the Functional Assessment of Cancer Therapy-Head and Neck Cancer) and for 5+ years for local recurrence, distant metastases, disease-specific survival, and overall survival. RESULTS: Twelve subjects enrolled from 3 centers. Two withdrew during radiation therapy and 1 within 14 weeks after radiation therapy. The remaining 9 had primary oropharyngeal disease and were stage IVA (7) or IVB (2). No dose-limiting toxicities were observed with daily HBO. Two patients (22%) required pressure equalization tubes. The average time between HBO and radiation therapy was 8.5 minutes, with 2 of 231 administrations delivered beyond 15 minutes (0.5%). Per-protocol analysis showed a clinical complete response in 7 and a pathologic complete response without tumor in salvage neck dissections in 2. With minimum follow-up of 61 months, per-protocol 5-year overall survival was 100%,local recurrence 0%, and distant metastases 11%. Patient-reported outcomes for quality of life (Functional Assessment of Cancer Therapy-Head and Neck Cancer) were comparable to published results for chemoradiotherapy without HBO. CONCLUSIONS: While acknowledging the study's small size and early attrition of 3 patients, our in-depth review of the acquired data indicates the feasibility of combining HBO with chemoradiation. Article Published Date : Feb 28, 2017

Abstract Title: Hyperbaric oxygen therapy is safe and effective for the treatment of sleep disorders in children with cerebral palsy. Abstract Source: Neurol Res. 2017 Mar ;39(3):239-247. Epub 2017 Jan 12. PMID: 28079475 Abstract Author(s): Ying Long, Jiewen Tan, Yulin Nie, Yu Lu, Xiufang Mei, Chaoqun Tu Article Affiliation: Ying Long Abstract: OBJECTIVE: To observe the effects of hyperbaric oxygen (HBO2) therapy on the treatment of sleep disorders and its safety in children with cerebral palsy (CP). METHODS: A total of 71 recruited children were divided into two groups based on age: group 1, aged between 2 and 4 years; and group 2, aged between 4 and 6 years. The effects of HBO2 therapy on sleep quality were observed. RESULTS: The total sleep items (TSIs) were significantly different in the two groups between pre-HBO2, post 10 HBO2 sessions, and post 20 HBO2 sessions (p < 0.01). A total of 15/38 (39.5%) participants in group 1 and 8/21 (38.0%) in group 2 presented difficulty in falling asleep; 17/38 (44.7%) in group 1 and 4/21 (19.0%) in group 2 had a short duration of sleep during the night; and 20/38 (52.6%) in group 1 and 11/21 (52.4%) in group 2 woke up easilyin the night. No significant difference in the average TSIs in 59 participants was found after 10 HBO2 sessions. Eight participants had insomnia after the first 5 sessions, and three in group 2 had nocturnal hyperkinesia after 15 sessions. A seizure during decompression was observed in 2/59 participants (2/419 sessions). DISCUSSION: These results indicate that HBO2 therapy is beneficial to improve sleep and is safe for children with CP; however, further studies are necessary to explore the mechanisms of HBO2 on sleep. Article Published Date : Feb 28, 2017

Abstract Title: Early hyperbaric oxygen therapy may improve the long term neurological consequences of diabetic patients suffering from hemorrhagic stroke. Abstract Source: Neurosci Lett. 2017 Feb 23 ;644:83-86. Epub 2017 Feb 23. PMID: 28237802 Abstract Author(s): Qian Xu, Yi-Ting Wei, Shuang-Bo Fan, Liang Wang, Xiao-Ping Zhou Article Affiliation: Qian Xu Abstract: BACKGROUND: Hyperbaric oxygen therapy (HBOT) is still a controversial alternative strategy for acute stroke. This study was conducted to evaluate the potential long-term efficacy and safety of using HBOT in diabetes patients with intracerebral hemorrhage (ICH). METHODS: In this randomized, prospective, normobaric oxygen therapy (NBOT)-controlled pilot study, 79 diabetes patients suffering from acute ICH were randomized to treat for 60min in a monoplace hyperbaric chamber pressurized with 100% O2 to 2.5-atm absolute (ATA) in the HBOT group or 1.5 ATA in the NBOT group. The primary outcomes included percentage of patients with improvement at one month and six months after onset (National Institutes of Health Stroke Scale [NIHSS], Barthel Index, modified Rankin Scale [mRS], Glasgow Outcome Scale [GOS]). The complications of all patients were recorded as well at the final follow-up of six months after onset. RESULTS: Baseline characteristics were similar in both groups. There were no statistical differences between two groups at one month. However, in the long-term follow-up of six months, a larger percentage of patients in the HBOT group had a good outcome defined by their stroke scores compared with the HBOT group (Barthel Index: 85.1% versus 65.6%, P=0.080; mRS: 89.4% versus 68.8%, P=0.045; GOS: 83.0% versus 62.5%, P=0.073; NIHSS: 80.9% versus 56.2%, P=0.035). CONCLUSIONS: In this study, early HBOT was found to be safe and effective with regards to the long term neurological consequences of diabetic patients suffering from ICH. Article Published Date : Feb 22, 2017

Abstract Title: Hyperbaric oxygen therapy for chronic ulcers in systemic sclerosis - case series. Abstract Source: Int J Dermatol. 2017 Feb 23. Epub 2017 Feb 23. PMID: 28233289 Abstract Author(s): Bengusu Mirasoglu, Bekir S Bagli, Samil Aktas Article Affiliation: Bengusu Mirasoglu Abstract: BACKGROUND: Digital and leg ulcers are extremely painful, hard to heal manifestations of systemic sclerosis (SSc). Many treatments have been tried for these challenging complications, but use of hyperbaric oxygen therapy (HBOT) is very limited. HBOT has been used as an adjunctive therapy for treating chronic wounds, and nonhealing SSc wounds, which have a hypoxic nature, may also benefit from it. METHODS: This is a retrospective analysis of six SSc patients who underwent HBOT for their ulcers. Patient demographics, ulcer properties, and details of treatments were evaluated. RESULTS: Three patients had digital ulcers, and the other three had leg ulcers. Three patients (two leg ulcers and one digital ulcer) had bilateral lesions. All patients had been treated for at least one and a half months with various modalities. After HBOT was applied, four patients' ulcers healed completely and two patients had near-complete healing. Amputation was not required for any. CONCLUSION: This case series, which has the largest patient population up to present, shows adjunctive HBOT may be helpful in the treatment of SSc ulcers. Article Published Date : Feb 22, 2017

Abstract Title: Hyperbaric oxygen treatment reverses radiation induced pro-fibrotic and oxidative stress responses in a rat model. Abstract Source: Free Radic Biol Med. 2017 Feb ;103:248-255. Epub 2016 Dec 27. PMID: 28034833 Abstract Author(s): N Oscarsson, L Ny, J Mölne, F Lind, S-E Ricksten, H Seeman-Lodding, D Giglio Article Affiliation: N Oscarsson Abstract: PURPOSE: Radiotherapy is effective in the treatment of tumors in the pelvic area but is associated with side effects such as cystitis and proctitis. Hyperbaric Oxygen Therapy (HBOT) has emerged as a treatment modality for radiation-induced side effects. In a rat model for radiation cystitis, we studied the effects of HBOT on oxidative stress and pro-fibrotic factors. MATERIALS AND METHODS: Sedated Sprague-Dawley rats underwent bladder irradiation of 20Gy with and without 20 sessions of HBOT during a fortnight. Control animals were treated with and without HBOT. All four groups of animals were euthanized 28 days later. Histopathological examinations, immunohistochemistry and quantitative polymerase chain reaction (qPCR) were used to analyze changes in oxidative stress (8-OHdG), anti-oxidative responses (SOD-1, SOD2, HO-1 and NRFα) and a panel of Th1-type and Th2-type cytokines (IL-1β, IL-4, IL-5, IL-6, IL-10, IL-13, TNF-α, TGF-β, IFN-γ) in the urinary bladder. RESULTS: Bladder irradiation increased the expression of 8-OHdG, SOD2, HO-1, NRFα, IL-10, TNF-α and tended to increase TGF-β. These changes were completely reversed by HBOT while HBOT in control animals had no effects on the studied markers for oxidative stress, anti-oxidative responses and Th1-type and Th2-type cytokines. CONCLUSIONS: Radiation induced a significant elevation of oxidative stress, antioxidants and pro-fibrotic factors in our animal model for radiation cystitis that were completely reversed and normalized by HBOT. Our findings indicate that HBOT may prevent radiation-induced changes by affecting oxidative stress and inflammatory cascades induced by radiation. SUMMARY: Radiotherapy may cause the development of chronic inflammation and fibrosis, significantly impairing organ function. We hypothesized that bladder irradiation induces an oxidative stress reaction, thereby triggering the redox system and thus initiating an inflammatory and pro-fibrotic response. We aimed to assess whether these changes would be reversed by hyperbaric oxygen using an animal model for radiation cystitis. Our study show that hyperbaric oxygen therapy may reverse oxidative stress and pro-inflammatory factors induced by radiation. Article Published Date : Jan 31, 2017

Abstract Title: Hyperbaric oxygen preconditioning improves postoperative cognitive dysfunction by reducing oxidant stress and inflammation. Abstract Source: Neural Regen Res. 2017 Feb ;12(2):329-336. PMID: 28400818 Abstract Author(s): Zhi-Xin Gao, Jin Rao, Yuan-Hai Li Article Affiliation: Zhi-Xin Gao Abstract: Postoperative cognitive dysfunction is a crucial public health issue that has been increasingly studied in efforts to reduce symptoms or prevent its occurrence. However, effective advances remain lacking. Hyperbaric oxygen preconditioning has proved to protect vital organs, such as the heart, liver, and brain. Recently, it has been introduced and widely studied in the prevention of postoperative cognitive dysfunction, with promising results. However, the neuroprotective mechanisms underlying this phenomenon remain controversial. This review summarizes and highlights the definition and application of hyperbaric oxygen preconditioning, the perniciousness and pathogenetic mechanism underlying postoperative cognitive dysfunction, and the effects that hyperbaric oxygen preconditioning has on postoperative cognitive dysfunction. Finally, we conclude that hyperbaric oxygen preconditioning is an effective and feasible method to prevent, alleviate, and improve postoperative cognitive dysfunction, and that its mechanism of action is very complex, involving the stimulation of endogenous antioxidant and anti-inflammation defense systems. Article Published Date : Jan 31, 2017

Abstract Title: Hyperbaric oxygen effects on depression-like behavior and neuroinflammation in traumatic brain injury rats. Abstract Source: World Neurosurg. 2017 Jan 5. Epub 2017 Jan 5. PMID: 28065873 Abstract Author(s): Sher-Wei Lim, Kuan-Chin Sung, Yow-Ling Shiue, Che-Chuan Wang, Chung-Ching Chio, Jinn-Rung Kuo Article Affiliation: Sher-Wei Lim Abstract: OBJECTIVE: The aim of this study was to determine whether hyperbaric oxygen (HBO) therapy causes attenuation of traumatic brain injury (TBI)-induced depression-like behavior and its associated anti-neuroinflammatory effects after fluid percussion injury. METHODS: Anesthetized male Sprague-Dawley rats were divided into three groups: sham operation + NBA (normobaric air: 21% O2 at 1 absolute atmosphere [ATA]), TBI + NBA, and TBI + HBO (100% O2 at 2.0 ATA). HBO was applied immediately for 60 min/day after TBI for 3 days. Depression-like behavior was tested by a forced-swimming test, motor function by an inclined plane test, and infarction volume by TTC staining on days 4, 8 and 15. Neuronal apoptosis (TUNEL assay), microglial (marker OX42) activation, and TNF-α expression in microglia in the hippocampus CA3 were measured by immunofluorescence methods. RESULTS: Compared to the TBI controls, without significant changes in triphenyltetrazolium chloride (TTC) staining or in the motor function test, TBI-induced depression-like behavior was significantly attenuated by HBO therapy by day 15 after TBI. Simultaneously, TBI-induced neuronal apoptosis, microglial (marker OX42) activation, and TNF-α expression in the microglia in the hippocampus CA3 were significantly reduced by HBO. CONCLUSIONS: Our results suggest that HBO treatment may ameliorate TBI-induced depression-like behavior in rats by attenuating neuroinflammation, representing one possible mechanism by which depression-like behavior recovery might occur. We also recommend HBO as a potential treatment for TBI-induced depression-like behavior if early intervention is possible. Article Published Date : Jan 04, 2017

Abstract Title: Hyperbaric oxygen therapy for a refractory skin ulcer after radical mastectomy and radiation therapy: a case report. Abstract Source: J Med Case Rep. 2017 Jan 4 ;11(1):5. Epub 2017 Jan 4. PMID: 28049509 Abstract Author(s): Mitsuhiro Enomoto, Kazuyoshi Yagishita, Kae Okuma, Takuya Oyaizu, Yasushi Kojima, Atsushi Okubo, Takuma Maeda, Satoko Miyamoto, Atsushi Okawa Article Affiliation: Mitsuhiro Enomoto Abstract: BACKGROUND: Radiation therapy is performed as an adjuvant therapy when indicated following surgical resection of malignant tumors. However, radiation exposure induces acute or chronic dermatitis, depending on the radiation dose, interval, tissue volume, or irradiated area of the body. Radiation-induced skin ulcers and osteomyelitis of the underlying bone are intractable late-stage complications of radiation therapy, and often require reconstructive surgery to cover exposed tissue. Hyperbaric oxygen therapy has been suggested as a treatment for delayed radiation injury with soft tissue and bony necrosis. CASE PRESENTATION: A 74-year-old Japanese female underwent left radical mastectomy for breast cancer (T3N3M0, stage IIIB) in 1987. Radiation therapy was initiated 6 weeks after the surgery. She received telecobalt-60 in a total dose of 50 Gy with 25 fractions to the left supraclavicular, parasternal and left axillary regions, and electron treatment (9 MeV) in a total dose of 50 Gy in 25 fractions to the left chest wall. After irradiation, her skin became thinner and more fragile on the left chest wall, but no severe infections were observed. She noticed a small ulcer that repeatedly healed and recurred in 2000. She visited the hospital where she received radiation therapy and was treated for a skin ulcer on the left chest wall in December 2012. A fistula developed and then pus was discharged in January 2013. She was referred to the hyperbaric medical center in February 2013, and the fistula (1.5× 3 cm) with pus discharge was observed. She was diagnosed with a late-onset radiation-induced skin ulcer that developed 25 years after radical mastectomy. HBO2 (2.5 atmospheres absolute with 100% oxygen for 60 minutes) was indicated for the refractory ulcer and osteomyelitis of the ribs. The patient was treated with HBO2 a total of 101 times over the course of 1 year and completely recovered. CONCLUSIONS: Hyperbaric oxygen therapy can be performed safely for even more than 100 sessions in patients with radiation-induced skin ulcers and osteomyelitis. Hyperbaric oxygen therapy can be considered as an alternative, conservative treatment when surgical resection for late-onset, radiation-induced skin ulcers is not indicated because of fragile skin in the irradiated areas. Article Published Date : Jan 03, 2017

Abstract Title: Reversal of Spinal Cord Ischemia Following Endovascular Thoracic Aortic Aneurysm Repair With Hyperbaric Oxygen and Therapeutic Hypothermia. Abstract Source: Vasc Endovascular Surg. 2017 Jan 1:1538574417725238. Epub 2017 Jan 1. PMID: 28820047 Abstract Author(s): Emmanuel Urquieta, Joseph Varon, Peter H Lin Article Affiliation: Emmanuel Urquieta Abstract: BACKGROUND: Neurological adverse events with spinal cord ischemia (SCI) remain one of the most feared complications in patients undergoing thoracic endovascular aortic repair (TEVAR). These patients can develop irreversible paraplegia with lifelong consequences with physical and psychological agony. CASE PRESENTATION: We herein present a patient who developed SCI with bilateral lower leg paraplegia on the third postoperative day following TEVAR. Spinal catheter was inserted for spinal fluid drainage. A hyperbaric oxygen therapy was initiated for 90 minutes for 2 days, which was followed by therapeutic hypothermia for 24 hours with a target temperature of 33°C. The patient exhibited significant neurological recovery following these treatments, and he ultimately regained full neurological function without spinal deficit. DISCUSSION: This represents the first reported case of full neurological recovery of a patient who developed complete SCI following TEVAR procedure. The neurological recovery was due in part to immediate therapeutic hypothermia and hyperbaric oxygen therapy which reversed the spinal ischemia. Article Published Date : Dec 31, 2016

Abstract Title: Oxygen-dependent regulation of tumor growth and metastasis in human breast cancer xenografts. Abstract Source: PLoS One. 2017 ;12(8):e0183254. Epub 2017 Aug 23. PMID: 28832662 Abstract Author(s): Kristine Yttersian Sletta, Maria K Tveitarås, Ning Lu, Agnete S T Engelsen, Rolf K Reed, Annette Garmann-Johnsen, Linda Stuhr Article Affiliation: Kristine Yttersian Sletta Abstract: BACKGROUND: Tumor hypoxia is relevant for tumor growth, metabolism, resistance to chemotherapy and metastasis. We have previously shown that hyperoxia, using hyperbaric oxygen treatment (HBOT), attenuates tumor growth and shifts the phenotype from mesenchymal to epithelial (MET) in the DMBA-induced mammary tumor model. This study describes the effect of HBOT on tumor growth, angiogenesis, chemotherapy efficacy and metastasis in a triple negative MDA-MB-231 breast cancer model, and evaluates tumor growth using a triple positive BT-474 breast cancer model. MATERIALS AND METHODS: 5 x 105 cancer cells were injected s.c. in the groin area of NOD/SCID female mice. The BT-474 group was supplied with Progesterone and Estradiol pellets 2-days prior to tumor cell injection. Mice were divided into controls (1 bar, pO2 = 0.2 bar) or HBOT (2.5 bar, pO2 = 2.5 bar, 90 min, every third day until termination of the experiments). Treatment effects were determined by assessment of tumor growth, proliferation (Ki67-staining), angiogenesis (CD31-staining), metastasis (immunostaining), EMT markers (western blot), stromal components collagen type I, Itgb1 and FSP1 (immunostaining) and chemotherapeutic efficacy (5FU). RESULTS: HBOT significantly suppressed tumor growth in both the triple positive and negative tumors, and both MDA-MB-231 and BT-474 showed a decrease in proliferation after HBOT. No differences were found in angiogenesis or 5FU efficacy between HBOT and controls. Nevertheless, HBOT significantly reduced both numbers and total area of the metastastatic lesions, as well as reduced expression of N-cadherin, Axl and collagen type I measured in the MDA-MB-231 model. No change in stromal Itgb1 and FSP1 was found in either tumor model. CONCLUSION: Despite the fact that behavior and prognosis of the triple positive and negative subtypes of cancer are different, the HBOT had a similar suppressive effect on tumor growth, indicating that they share a common oxygen dependent anti-tumor mechanism. Furthermore, HBOT significantly reduced the number and area of metastatic lesions in the triple negative model as well as a significant reduction in the EMT markers N-cadherin, Axl and density of collagen type I. Article Published Date : Dec 31, 2016

Abstract Title: Hyperbaric Oxygen Therapy Can Induce Angiogenesis and Regeneration of Nerve Fibers in Traumatic Brain Injury Patients. Abstract Source: Front Hum Neurosci. 2017 ;11:508. Epub 2017 Oct 19. PMID: 29097988 Abstract Author(s): Sigal Tal, Amir Hadanny, Efrat Sasson, Gil Suzin, Shai Efrati Article Affiliation: Sigal Tal Abstract: Background: Recent clinical studies in stroke and traumatic brain injury (TBI) victims suffering chronic neurological injury present evidence that hyperbaric oxygen therapy (HBOT) can induce neuroplasticity. Objective: To assess the neurotherapeutic effect of HBOT on prolonged post-concussion syndrome (PPCS) due to TBI, using brain microstructure imaging. Methods: Fifteen patients afflicted with PPCS were treated with 60 daily HBOT sessions. Imaging evaluation was performed using Dynamic Susceptibility Contrast-Enhanced (DSC) and Diffusion Tensor Imaging (DTI) MR sequences. Cognitive evaluation was performed by an objective computerized battery (NeuroTrax). Results: HBOT was initiated 6 months to 27 years (10.3± 3.2 years) from injury. After HBOT, DTI analysis showed significantly increased fractional anisotropy values and decreased mean diffusivity in both white and gray matter structures. In addition, the cerebral blood flow and volume were increased significantly. Clinically, HBOT induced significantimprovement in the memory, executive functions, information processing speed and global cognitive scores. Conclusions: The mechanisms by which HBOT induces brain neuroplasticity can be demonstrated by highly sensitive MRI techniques of DSC and DTI. HBOT can induce cerebral angiogenesis and improve both white and gray microstructures indicating regeneration of nerve fibers. The micro structural changes correlate with the neurocognitive improvements. Article Published Date : Dec 31, 2016

Abstract Title: Repetitive hyperbaric oxygen treatment increases insulin sensitivity in diabetes patients with acute intracerebral hemorrhage. Abstract Source: Neuropsychiatr Dis Treat. 2017 ;13:421-426. Epub 2017 Feb 10. PMID: 28228657 Abstract Author(s): Qian Xu, Yi-Ting Wei, Shuang-Bo Fan, Liang Wang, Xiao-Ping Zhou Article Affiliation: Qian Xu Abstract: AIM: The role of hyperbaric oxygen therapy (HBOT) in the treatment of acute ischemic stroke is controversial. This study aims to investigate whether the peripheral insulin sensitivity of type 2 diabetes patients suffering from intracerebral hemorrhage can be increased after HBOT. METHODS: Fifty-two type 2 diabetes participants were recruited after being diagnosed with intracerebral hemorrhage in our hospital. Insulin sensitivity was measured by the glucose infusion rate during a hyperinsulinemic euglycemic clamp (80 mU m(-2) min(-1)) at baseline and 10 and 30 days after HBOT sessions. Serum insulin, fasting glucose, and hemoglobin A1C were measured in fasting serum at baseline and after HBOT sessions. In addition, early (∼10 days after onset) and late (1 month after onset) outcomes (National Institutes of Health Stroke Scale, NIHSS scores) and efficacy (changes of NIHSS scores) of HBOT were evaluated. RESULTS: In response to HBOT, the glucose infusion rate was increased by 37.8%±5.76% at 1 month after onset compared with baseline. Reduced serum insulin, fasting glucose, and hemoglobin A1C were observed after HBOT. Both early and late outcomes of the HBOT group were improved compared with baseline (P<0.001). In the control group, there was significant difference only in the late outcome (P<0.05). In the assessment of efficacy, there were statistically significant differences between the groups when comparing changes in NIHSS scores at 10 days and 1 month after onset (P<0.05). CONCLUSION: Peripheral insulin sensitivity was increased following HBOT in type 2 diabetes patients with intracerebral hemorrhage. The HBOT used in this study may be effective for diabetes patients with acute stroke and is a safe and harmless adjunctive treatment. Article Published Date : Dec 31, 2016

Abstract Title: The efficacy of hyperbaric oxygen therapy related to the clinical stage of osteoradionecrosis of the mandible. Abstract Source: Int J Oral Maxillofac Surg. 2016 Dec 30. Epub 2016 Dec 30. PMID: 28043745 Abstract Author(s): F J Dieleman, T T T Phan, F J A van den Hoogen, J H A M Kaanders, M A W Merkx Article Affiliation: F J Dieleman Abstract: This study aimed to evaluate the success of hyperbaric oxygen therapy (HBOT) and surgery in the treatment of mandibular osteoradionecrosis (ORN) in relation to the extent of the ORN. Twenty-seven patients with ORN were identified from a total of 509 patients with a history of primary oral or base of the tongue cancer; these patients had been treated with radiation therapy with curative intent between 1992 and 2006, with a radiation dose to the mandible of≥50Gy. The ORN was staged according to the classification of Notani et al. The time from completion of radiation therapy to the development of ORN varied (median 3 years). Forty HBOT sessions were offered. After HBOT alone, 3 of 11 stage I lesions, 0 of 8 stage II lesions, and 0 of 8 stage III lesions had healed (P=0.0018). An absolute incidence of 5.3% ORN was found in this population. Of all sites irradiated in this study, the floor of the mouth was most associated with ORN (8.6%), whereas the cheek was least associated (0%). Based on the results of this study, HBOT can be recommended forstage I and II ORN and for selected cases of stage III ORN. Article Published Date : Dec 29, 2016

Abstract Title: Systematic review of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. Abstract Source: J Plast Reconstr Aesthet Surg. 2016 Dec 14. Epub 2016 Dec 14. PMID: 28081957 Abstract Author(s): Zachary Borab, Michael D Mirmanesh, Madeleine Gantz, Alessandro Cusano, Lee L Q Pu Article Affiliation: Zachary Borab Abstract: Every year, 1.2 million cancer patients receive radiation therapy in the United States. Late radiation tissue injury occurs in an estimated 5-15% of these patients. Tissue injury can include skin necrosis, which can lead to chronic nonhealing wounds. Despite many treatments available to help heal skin necrosis such as hyperbaric oxygen therapy, no clinical guidelines exist and evidence is lacking. The purpose of this review is to identify and comprehensively summarize studies published to date to evaluate the effectiveness of hyperbaric oxygen therapy for the treatment of radiation-induced skin necrosis. Adhering to PRISMA guidelines, a systematic review of currently published articles was performed, evaluating the use of hyperbaric oxygen to treat skin necrosis. Eight articles were identified, including one observational cohort, five case series, and two case reports. The articles describe changes in symptoms and alteration in wound healing of radiation-induced skin necrosis after treatment with hyperbaric oxygen therapy. Hyperbaric oxygen therapy is a safe intervention with promising outcomes; however, additional evidence is needed to endorse its application as a relevant therapy in the treatment of radiation-induced skin necrosis. Article Published Date : Dec 13, 2016

Abstract Title: The effectiveness of hyperbaric oxygen therapy (HBOT) in radiation-induced haemorrhagic cystitis. Abstract Source: N Z Med J. 2016 Dec 2 ;129(1446):79-83. Epub 2016 Dec 2. PMID: 27906922 Abstract Author(s): Vincent Chong, Michael Rice Article Affiliation: Vincent Chong Abstract: INTRODUCTION: Radiation cystitis is one of the possible complications from pelvic radiotherapy. Hyperbaric oxygen (HBOT) improves tissue oxygenation and healing of scarred tissue. AIMS: To assess the efficacy of hyperbaric oxygen therapy (HBOT) in the management of radiation-induced haemorrhagic cystitis in patients with urological cancers. METHODS: This is a retrospective review on all patients with macroscopic haematuria secondary to radiation induced haemorrhagic cystitis who were treated with hyperbaric oxygen therapy (HBOT) between 2009 and 2013. The primary outcome is symptomatic assessment (either complete resolution, partial resolution or no change). RESULTS: A total of 12 patients with radiation-induced cystitis secondary to urological cancer were included in this study with a mean follow-up of 443 days. The mean age was 78 years. Complete resolution of haematuria was seen in six out of 12 patients. Partial response was achieved in two patients where one required two courses of HBOT and one required three courses of HBOT. As a result, the overall improvement of haematuria after HBOT was 67%. A total of four patients had no response to HBOT. CONCLUSION: Radiation-induced cystitis is a difficult clinical problem to treat. HBOT is not a magic bullet but it may be another alternative treatment option we have at this point in time. Article Published Date : Dec 01, 2016

Abstract Title: Effects of hyperbaric oxygen therapy on RAGE and MCP-1 expression in rats with spinal cord injury. Abstract Source: Mol Med Rep. 2016 Dec ;14(6):5619-5625. Epub 2016 Nov 9. PMID: 27840972 Abstract Author(s): Yong Wang, Chunsheng Li, Chunjin Gao, Zhuo Li, Jing Yang, Xuehua Liu, Fang Liang Article Affiliation: Yong Wang Abstract: The inflammatory response is an important source of secondary damage to neuronal tissue in the spinal cord following spinal cord injury (SCI). Hyperbaric oxygen (HBO) therapy reduces inflammation and promotes the restoration of locomotor function following SCI, however, the mechanisms underlying this effect remain to be determined. The aim of the current study was to investigate the mechanisms by which HBO therapy promotes recovery in a rat model of SCI by measuring expression levels of receptor for advanced glycation end products (RAGE) and monocyte chemoattractant protein‑1 (MCP‑1) in spinal cord tissue. Experimental animals (n=90) were divided into three groups: Sham‑operated (SH), SCI (T‑10 laminectomy) and SCI + HBO. Each group was further divided into five subgroups (n=6) that were examined at 12 h, and at 1, 3, 7 and 14 days post‑injury. Recoveryof locomotor function was evaluated using the Basso, Beattie and Bresnahan (BBB) scoring system. Neutrophil infiltration was analyzed using myeloperoxidase (MPO) activity assays. The expression of RAGE and MCP‑1 was measured by immunohistochemistry, reverse transcription‑quantitative polymerasechain reaction and western blotting. RAGE and MCP‑1 expression and MPO activity were higher in the SCI groups than in the SH groups at each time point. HBO therapy reduced RAGE and MCP‑1 expression and MPO activity compared with untreated, injured animals at early post‑injury stages. In addition, HBO therapy improved BBB scores at post‑operative day 7 and 14. HBO therapy was, therefore, demonstrated to relieve secondary inflammatory responses, potentially by inhibiting the expression of RAGE and MCP‑1, resulting in significant recovery of locomotor function. The results of the present study may, therefore, be useful in improving the clinical application of HBO therapy for patients with SCI. Article Published Date : Nov 30, 2016

Abstract Title: Radiotherapy using IMRT boosts after hyperbaric oxygen therapy with chemotherapy for glioblastoma. Abstract Source: J Radiat Res. 2016 Nov 17. Epub 2016 Nov 17. PMID: 27864508 Abstract Author(s): Katsuya Yahara, Takayuki Ohguri, Hiroki Udono, Junkoh Yamamoto, Kyosuke Tomura, Toshihiro Onoda, Hajime Imada, Shigeru Nishizawa, Yukunori Korogi Article Affiliation: Katsuya Yahara Abstract: The purpose of this study was to evaluate the feasibility and efficacy of radiotherapy (RT) using intensity-modulated radiotherapy (IMRT) boosts after hyperbaric oxygen (HBO) therapy with chemotherapy in patients with glioblastoma. Twenty-four patients with glioblastoma were treated with the combined therapy, which was RT using IMRT boosts after HBO with chemotherapy, and were retrospectively analyzed. The RT protocol was as follows: first, 3D conformal RT [40 Gy/20 fractions (fr)] was delivered to the gross tumor volume (GTV) and the surrounding edema, including an additional 1.5-2.0 cm. The IMRT boost doses were then continuously delivered to the GTV plus 5 mm (28 Gy/8 fr) and the surrounding edema (16 Gy/8 fr). Each IMRT boost session was performed immediately after HBO to achieve radiosensitization. The planned RT dose was completed in all patients, while HBO therapy was terminated in one patient (4%) due to Grade 2 aural pain. The toxicities were mild, no non-hematological toxicity of Grade 3-5 was observed. The 2-year overall survival (OS) and progression-free survival rates in all patients were 46.5% and 35.4%, respectively. The median OS time was 22.1 months. In conclusion, the combined therapy of RT using IMRT boosts after HBO with chemotherapy was a feasible and promising treatment modality for patients with glioblastoma. The results justify further evaluation to clarify the benefits of this therapy. Article Published Date : Nov 16, 2016

Abstract Title: Transient osteoporosis of the hip treated with hyperbaric oxygen therapy: a case series. Abstract Source: Undersea Hyperb Med. 2016 Nov-Dec;43(7):847-854. PMID: 28777523 Abstract Author(s): Kazuyoshi Yagishita, Tetsuya Jinno, Daisuke Koga, Tsuyoshi Kato, Mitsuhiro Enomoto, Tsuyoshi Kato, Takeshi Muneta, Atsushi Okawa Article Affiliation: Kazuyoshi Yagishita Abstract: INTRODUCTION: Transient osteoporosis of the hip (TOH) is a self-limiting disorder characterized by bone marrow edema at the femoral head and neck. Patients report pain as moderate or severe at onset; pain gradually subsides at about six months (range four to 12 months). Differential diagnosis of the early stages of osteonecrosis of the femoral head (ONFH) is sometimes difficult. Because hyperbaric oxygen (HBO₂) therapy is effective for reduction of edema in soft tissue injury and early stages of ONFH, we hypothesized that HBO₂ could be effective in TOH for accelerated recovery. METHODS: Five cases of TOH treated with HBO₂ were clinically evaluated. HBO₂ was started from three to eight weeks after onset and performed four or five times a week, averaging a total of 27.8 ± 4.7 treatments (range 20-32). Clinical features were evaluated repeatedly with clinical examination, subjective evaluation of pain, and imaging methods that included magnetic resonance imaging (MRI) and bone scans. RESULTS: The average time to return-to-normal hip range of motion was 15.4± 7.8 weeks after onset, and relief of subjective pain was 16.6 ± 4.0 weeks. The average time to return-to-normal signal level in MRI was 22.0 ± 2.5 weeks, which was one to two months after relief of subjective pain. COMCLUSIONS: Multiple HBO₂ treatments have the possibility of contributing to recovery acceleration in patients with TOH. However, in this study, we found that HBO₂ treatment did not significantly accelerate the recovery of these five patients with TOH. The use of HBO₂ should therefore be limited to patients in whom the differential diagnosis between TOH and early stage ONFH cannot be established. Article Published Date : Oct 31, 2016

Abstract Title: Hyperbaric oxygen therapy sensitizes nimustine treatment for glioma in mice. Abstract Source: Cancer Med. 2016 Nov ;5(11):3147-3155. Epub 2016 Oct 13. PMID: 27734611 Abstract Author(s): Zhaohui Lu, Jiawei Ma, Bing Liu, Chungang Dai, Tao Xie, Xiaoyu Ma, Ming Li, Jun Dong, Qing Lan, Qiang Huang Article Affiliation: Zhaohui Lu Abstract: Nimustine (ACNU) has antitumor activities in patients with malignant glioma. Hyperbaric oxygen (HBO) may enhance the efficacy of certain therapies that are hampered by the hypoxic microenvironment. We examined the combined effects of ACNU and HBO in a GFP transgenic nude mice bearing human glioma model. Mice inoculated with human glioma cells SU3 were randomly divided into the four groups: (A) the control group, (B) the HBOT (HBO therapy) group, (C) the ACNU group, and (D) the HBOT+ACNU group. Tumor size was measured at the indicated time intervals with a caliper; mice were sacrificed 28 days after treatment, and immunohistochemistry staining and western blot analysis were carried out. By the end of the trial, the tumor weights of groups A, B, C, and D were (P < 0.05), 6.03 ± 1.47, 4.13 ± 1.82 (P < 0.05), 2.39 ± 0.25 (P < 0.05), and 1.43 ± 0.38 (P < 0.01), respectively. The expressions of TNF-α, MMP9, HIF-α, VEGF, NF-κB, and IL-1β were associated with the infiltration of inflammatory cells and the inhibition rate of tumor cells. Hyperbaric oxygen therapy (HBOT) could inhibit glioma cell proliferation and inflammatory cell infiltration, and exert a sensitizing effect on ACNU therapy partially through enhancing oxygen pressure (PO2 ) in tumor tissues and lower expression levels of HIF-1α, TNF-α, IL-1β, VEGF, MMP9, and NF-κB. Article Published Date : Oct 31, 2016

Abstract Title: Neuroprotective effect of hyperbaric oxygen therapy in a juvenile rat model of repetitive mild traumatic brain injury. Abstract Source: Med Gas Res. 2016 Oct-Dec;6(4):187-193. Epub 2016 Dec 30. PMID: 28217290 Abstract Author(s): Lei Huang, Andre Obenaus, Mary Hamer, John H Zhang Article Affiliation: Lei Huang Abstract: Repetitive mild traumatic brain injury (rmTBI) is an important medical concern for adolescent athletes that can lead to long-term disabilities. Multiple mild injuries may exacerbate tissue damage resulting in cumulative brain injury and poor functional recovery. In the present study, we investigated the increased brain vulnerability to rmTBI and the effect of hyperbaric oxygen treatment using a juvenile rat model of rmTBI. Two episodes of mild cortical controlled impact (3 days apart) were induced in juvenile rats. Hyperbaric oxygen (HBO) was applied 1 hour/day× 3 days at 2 atmosphere absolute consecutively, starting at 1 day after initial mild traumatic brain injury (mTBI). Neuropathology was assessed by multi-modal magnetic resonance imaging (MRI) and tissue immunohistochemistry. After repetitive mTBI, there were increases in T2-weighted imaging-defined cortical lesions and susceptibility weighted imaging-defined cortical microhemorrhages, correlated with brain tissue gliosis at the site of impact. HBO treatment significantly decreased the MRI-identified abnormalities and tissue histopathology. Our findings suggest that HBO treatment improves thecumulative tissue damage in juvenile brain following rmTBI. Such therapy regimens could be considered in adolescent athletes at the risk of repeated concussions exposures. Article Published Date : Sep 30, 2016

Abstract Title: Hyperbaric oxygen therapy for late radiation-induced tissue toxicity: prospectively patient-reported outcome measures in breast cancer patients. Abstract Source: Radiat Oncol. 2016 Sep 29 ;11(1):130. Epub 2016 Sep 29. PMID: 27682427 Abstract Author(s): David N Teguh, René Bol Raap, Henk Struikmans, Cees Verhoef, Linetta B Koppert, Arne Koole, Yadi Huang, Rob A van Hulst Article Affiliation: David N Teguh Abstract: INTRODUCTION: This study examines patient reported outcome measures of women undergoing hyperbaric oxygen treatment (HBOT) after breast-conserving therapy. METHOD: Included were 57 women treated with HBOT for late radiation-induced tissue toxicity (LRITT) referred in the period January 2014-December 2015. HBOT consisted of (on average) 47 sessions. In total, 80 min of 100 % O2 was administered under increased pressure of 2.4 ATA. Quality of life was assessed before and after treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23, and a NRS pain score. RESULTS: Fifty-seven women were available for evaluation before and after treatment. Before HBOT, patients had severe complaints of pain in the arm/shoulder (46 %), swollen arm/hand (14 %), difficulty to raise arm or move it sideways (45 %), pain in the area of the affected breast (67 %), swollen area of the affected breast (45 %), oversensitivity of the affected breast (54 %), and skin problems on/in the area of the affected breast (32 %); post HBOT, severe complaints were still experienced in 17, 7, 22, 15, 13, 15, and 11 % of the women, respectively. Differences were all significant. The NRS pain score improved at least 1 point (range 0-10) in 81 % of the patients (p < 0.05). CONCLUSION: In these breast cancer patients treated with HBOT for LRITT, the patient-reported outcomes were positive and improvements were observed. HBOT was a well-tolerated treatment for LRITT and its side-effects were both minimal and reversible. Article Published Date : Sep 28, 2016

Abstract Title: Hyperbaric oxygen as an adjunctive therapy in treatment of malignancies, including brain tumours. Abstract Source: Med Oncol. 2016 Sep ;33(9):101. Epub 2016 Aug 2. PMID: 27485098 Abstract Author(s): Katarzyna Stępień, Robert P Ostrowski, Ewa Matyja Article Affiliation: Katarzyna Stępień Abstract: Hyperbaric oxygen (HBO) therapy is widely used as an adjunctive treatment for various pathological states, predominantly related to hypoxic and/or ischaemic conditions. It also holds promise as an approach to overcoming the problem of oxygen deficiency in the poorly oxygenated regions of the neoplastic tissue. Occurrence of local hypoxia within the central areas of solid tumours is one of the major issues contributing to ineffective medical treatment. However, in anti-cancer therapy, HBO alone gives a limited curative effect and is typically not applied by itself. More often, HBO is used as an adjuvant treatment along with other therapeutic modalities, such as radio- and chemotherapy. This review outlines the existing data regarding the medical use of HBO in cancer treatment, with a particular focus on the use of HBO in the treatment of brain tumours. We conclude that the administration of HBO can provide many clinical benefits in the treatment of tumours, including management of highly malignant gliomas. Applied immediately before irradiation, it is safe and well tolerated by patients, causing rare and limited side effects. The results obtained with a combination of HBO/radiotherapy protocol proved to be especially favourable compared to radiation treatment alone. HBO can also increase the cytostatic effect of certain drugs, which may render standard chemotherapy more effective. The currently available data support the legitimacy of conducting further research on the use of HBO in the treatment of malignancies. Article Published Date : Aug 31, 2016

Abstract Title: Hyperbaric oxygen treatment suppresses withdrawal signs in morphine-dependent mice. Abstract Source: Brain Res. 2016 Aug 14. Epub 2016 Aug 14. PMID: 27534375 Abstract Author(s): Daniel Nicoara, Yangmiao Zhang, Jordan T Nelson, Abigail L Brewer, Prianka Maharaj, Shea N DeWald, Donald Y Shirachi, Raymond M Quock Article Affiliation: Daniel Nicoara Abstract: Hyperbaric oxygen (HBO2) therapy reportedly reduces opiate withdrawal in human subjects. The purpose of this research was to determine whether HBO2 treatment could suppress physical signs of withdrawal in opiate-dependent mice. Male NIH Swiss mice were injected s.c. with morphine sulfate twice a day for 4 days, the daily dose gradually increasing from 50mg/kg on day 1 to 125mg/kg on day 4. On day 5, withdrawal was precipitated by i.p. injection of 5.0mg/kg naloxone. Mice were observed for physical withdrawal signs, including jumping, forepaw tremor, wet-dog shakes, rearing and defecation for 30min. Sixty min prior to the naloxone injection, different groups of mice received either a 30-min or 60-min HBO2 treatment at 3.5 atm absolute. HBO2 treatment significantly reduced naloxone-precipitated jumping, forepaw tremor, wet-dog shakes, rearing and defecation. Based on these experimental findings, we concluded that treatment with HBO2 can suppress physical signs of withdrawal syndrome in morphine-dependent mice. Article Published Date : Aug 13, 2016

Abstract Title: Hyperbaric oxygen therapy improves colorectal anastomotic healing. Abstract Source: Int J Colorectal Dis. 2016 May ;31(5):1031-8. Epub 2016 Apr 4. PMID: 27041554 Abstract Author(s): G S A Boersema, Z Wu, L F Kroese, S Vennix, Y M Bastiaansen-Jenniskens, J W van Neck, K H Lam, G J Kleinrensink, J Jeekel, J F Lange Article Affiliation: G S A Boersema Abstract: PURPOSE: Hyperbaric oxygen treatment (HBOT) has been found to improve the healing of poorly oxygenated tissues. This study aimed to investigate the influence of HBOT on the healing in ischemic colorectal anastomosis. METHODS: Forty Wistar rats were randomly divided into a treatment group that received HBOT for 10 consecutive days (7 days before and 3 days after surgery), or in a control group, which did not receive the therapy. Colectomy with an ischemic anastomosis was performed in all rats. In each group, the rats were followed for 3 or 7 days after surgery to determine the influence of HBOT on anastomotic healing. RESULTS: Five rats from each group died during follow-up. No anastomotic dehiscence was seen in the HBOT group, compared to 37.5 % and 28.6 % dehiscence in the control group on postoperative day (POD) 3 and 7, respectively. The HBOT group had a significantly higher bursting pressure (130.9 ± 17.0 mmHg) than the control group (88.4 ± 46.7 mmHg; p = 0.03) on POD 3. On POD 3 and POD 7, the adhesion severity was significantly higher in the control groups than in the HBOT groups (p < 0.005). Kidney function (creatinine level) of the HBOT group was significantly better than of the control group on POD 7 (p = 0.001). Interestingly, a significantly higher number of CD206+ cells (marker for type 2 macrophages) was observed in the HBOT group at the anastomotic area on POD 3. CONCLUSION: Hyperbaric oxygen enhanced the healing of ischemic anastomoses in rats and improved the postoperative kidney function. Article Published Date : Apr 30, 2016

Abstract Title: Evaluation of Hyperbaric Oxygen Therapy in the Treatment of Radiation-Induced Haemorrhagic Cystitis. Abstract Source: Urology. 2016 Apr 25. Epub 2016 Apr 25. PMID: 27125879 Abstract Author(s): Julien Mougin, Vincent Souday, François Martin, Abdel Rahmène Azzouzi, Pierre Bigot Article Affiliation: Julien Mougin Abstract: OBJECTIVE: To evaluate the efficacy of hyperbaric oxygen therapy (HBO) in the treatment of post-radiation haematuria (PRH) and to identify the predictive factors for a successful outcome. MATERIALS AND METHODS: We conducted a retrospective study and included all patients treated with HBO for PRH in a university hospital centre between January 2003 and December 2013. We studied the patients' clinical characteristics, radiotherapy indication, treatments preceding HBO, the grade of haematuria diagnosed based on the CTCAE classification v 4.03 and the efficacy of HBO. The success of HBO was defined as the total or partial resolution of haematuria. RESULTS: We included 71 patients with a median age of 72 (39-87) years. PRHs were severe (grade≥3) in 50 (70.4%) of the cases. Radiotherapy was indicated in the treatment of prostate cancer in 61 (85.9%) patients. The median length of time between haematuria and HBO was 8 (1-154) months. Prior to HBO, 46 (64.8%) patients underwent electrocoagulation of the bladder. HBO sessions were compounded by 9 cases of barotraumatic otitis, 5 cases of transient visual disturbance, and one case of finger paresthesia. On average, 29 (3-50) sessions were carried out. Treatment was effective in 46 (64.8%) patients, 37 (52.1%) of whom were completely cured. A haematuria grade of less than 3 was a predictive factor in successful treatment (p=0.027). Median follow-up was 15 (1-132) months. CONCLUSION: Hyperbaric oxygen therapy completely resolves post-radiation haematuria in 52.1% of cases. Prolonged patient follow-up is required in order to confirm the efficacy of this treatment. Article Published Date : Apr 24, 2016

Abstract Title: Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study. Abstract Source: Acta Neurochir (Wien). 2016 Apr 25. Epub 2016 Apr 25. PMID: 27113742 Abstract Author(s): Jiri Bartek, Asgeir S Jakola, Simon Skyrman, Petter Förander, Peter Alpkvist, Gaston Schechtmann, Martin Glimåker, Agneta Larsson, Folke Lind, Tiit Mathiesen Article Affiliation: Jiri Bartek Abstract: BACKGROUND: There is a need to improve outcome in patients with brain abscesses and hyperbaric oxygen therapy (HBOT) is a promising treatment modality. The objective of this study was to evaluate HBOT in the treatment of intracranial abscesses. METHOD: This population-based, comparative cohort study included 40 consecutive adult patients with spontaneous brain abscess treated surgically between January 2003 and May 2014 at our institution. Twenty patients received standard therapy with surgery and antibiotics (non-HBOT group), while the remaining 20 patients also received adjuvant HBOT (HBOT group). RESULTS: Resolution of brain abscesses and infection was seen in all patients. Two patients had reoperations after HBOT initiation (10 %), while nine patients (45 %) in the non-HBOT group underwent reoperations (p = 0.03). Of the 26 patients who did not receive HBOT after the first surgery, 15 (58 %) had one or several recurrences that lead to a new treatment: surgery (n = 11), surgery + HBO (n = 5) or just HBO(n = 1). In contrast, recurrences occurred in only 2 of 14 (14 %) who did receive HBOT after the first surgery (p < 0.01). A good outcome (Glasgow Outcome Score [GOS] of 5) was achieved in 16 patients (80 %) in the HBOT cohort versus 9 patients (45 %) in the non-HBOT group (p = 0.04). CONCLUSIONS: HBOT was associated with less treatment failures and need for reoperation and seemingly with improved long-term outcome. Further, HBOT was well tolerated and safe. Prospective studies are warranted to establish the role of HBOT in the treatment of brain abscesses. Article Published Date : Apr 24, 2016

Abstract Title: Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria. Abstract Source: Infect Immun. 2016 Apr ;84(4):874-82. Epub 2016 Mar 24. PMID: 26831465 Abstract Author(s): Ana Carolina A V Kayano, João Conrado K Dos-Santos, Marcele F Bastos, Leonardo J Carvalho, Júlio Aliberti, Fabio T M Costa Article Affiliation: Ana Carolina A V Kayano Abstract: Over 200 million people worldwide suffer from malaria every year, a disease that causes 584,000 deaths annually. In recent years, significant improvements have been achieved on the treatment of severe malaria, with intravenous artesunate proving superior to quinine. However, mortality remains high, at 8% in children and 15% in adults in clinical trials, and even worse in the case of cerebral malaria (18% and 30%, respectively). Moreover, some individuals who do not succumb to severe malaria present long-term cognitive deficits. These observations indicate that strategies focused only on parasite killing fail to prevent neurological complications and deaths associated with severe malaria, possibly because clinical complications are associated in part with a cerebrovascular dysfunction. Consequently, different adjunctive therapies aimed at modulating malaria pathophysiological processes are currently being tested. However, none of these therapies has shown unequivocal evidence in improving patient clinical status. Recently, key studies have shown that gaseous therapies based mainly on nitric oxide (NO), carbon monoxide (CO), and hyperbaric (pressurized) oxygen (HBO) alter vascular endothelium dysfunction and modulate the host immune response to infection. Considering gaseous administration as a promising adjunctive treatment against severe malaria cases, we review here the pathophysiological mechanisms and the immunological aspects of such therapies. Article Published Date : Mar 31, 2016

Abstract Title: Hyperbaric oxygen therapy for traumatic brain injury: bench-to-bedside. Abstract Source: Med Gas Res. 2016 Apr-Jun;6(2):102-110. Epub 2016 Jul 11. PMID: 27867476 Abstract Author(s): Qin Hu, Anatol Manaenko, Ting Xu, Zhenni Guo, Jiping Tang, John H Zhang Article Affiliation: Qin Hu Abstract: Traumatic brain injury (TBI) is a serious public health problem in the United States. Survivors of TBI are often left with significant cognitive, behavioral, and communicative disabilities. So far there is no effective treatment/intervention in the daily clinical practice for TBI patients. The protective effects of hyperbaric oxygen therapy (HBOT) have been proved in stroke; however, its efficiency in TBI remains controversial. In this review, we will summarize the results of HBOT in experimental and clinical TBI, elaborate the mechanisms, and bring out our current understanding and opinions for future studies. Article Published Date : Mar 31, 2016

Abstract Title: A rare case of primary necrotising fasciitis of the breast: combined use of hyperbaric oxygen and negative pressure wound therapy to conserve the breast. Review of literature. Abstract Source: Int Wound J. 2016 May 5. Epub 2016 May 5. PMID: 27146346 Abstract Author(s): Francesco Marongiu, Federico Buggi, Matteo Mingozzi, Annalisa Curcio, Secondo Folli Article Affiliation: Francesco Marongiu Abstract: Necrotising fasciitis is a rare but potentially fatal disease. It is even more unusual as a primary disease of the breast. Surgical treatment is required in order to gain control over the spreading infection and mastectomy is reported to be the most common procedure. We report the first case of an otherwise healthy woman exhibiting a primary necrotising fasciitis of the breast, which was treated combining conservative surgery with hyperbaric oxygen (HO) and negative pressure wound therapy (NPWT). A 39-year-old woman presented to the emergency room with fever and swelling of her right breast. The physical examination showed oedema and erythema of the breast, with bluish blisters on the lower quadrant. Ultrasound and CT scans showed diffuse oedema of the entire right breast, with subdermal gas bubbles extending to the fascial planes. Few hours later the necrotic area extended regardless an IV antibiotic therapy; a selective debridement of all breast necrotic tissue was performed and repeated 7 days later. The HO was started immediately after the first surgery and repeated daily (2·8 Bar, 120 min) for 18 days and then a NPWT (120-135 mmHg) was applied. Forty-five days after the last debridement, the breast wound was covered with a full-thickness skin graft. Several months later,an excellent cosmetic result was observed. This is the first case of primary necrotising fasciitis of the breast treated associating HO and NPWT to surgical debridement only; this combination resulted in a complete recovery with the additional benefit of breast conservation. Such result is discussedin light of the available literature on the treatment of primary necrotising fasciitis of the breast. Article Published Date : May 04, 2016

Abstract Title: Reinforcement of the bactericidal effect of ciprofloxacin on Pseudomonas aeruginosa biofilm by hyperbaric oxygen treatment. Abstract Source: Int J Antimicrob Agents. 2016 Feb ;47(2):163-7. Epub 2015 Dec 29. PMID: 26774522 Abstract Author(s): Mette Kolpen, Nabi Mousavi, Thomas Sams, Thomas Bjarnsholt, Oana Ciofu, Claus Moser, Michael Kühl, Niels Høiby, PeterØstrup Jensen Article Affiliation: Mette Kolpen Abstract: Chronic Pseudomonas aeruginosa lung infection is the most severe complication in cystic fibrosis patients. It is characterised by antibiotic-tolerant biofilms in the endobronchial mucus with zones of oxygen (O2) depletion mainly due to polymorphonuclear leucocyte activity. Whilst the exact mechanisms affecting antibiotic effectiveness on biofilms remain unclear, accumulating evidence suggests that the efficacy of several bactericidal antibiotics such as ciprofloxacin is enhanced by stimulation of the aerobic respiration of pathogens, and that lack of O2 increases their tolerance. Reoxygenation of O2-depleted biofilms may thus improve susceptibility to ciprofloxacin possibly by restoring aerobic respiration. We tested such a strategy using reoxygenation of O2-depleted P. aeruginosa strain PAO1 agarose-embedded biofilms by hyperbaric oxygen treatment (HBOT) (100% O2, 2.8bar), enhancing the diffusive supply for aerobic respiration during ciprofloxacin treatment. This proof-of-principle study demonstrates that biofilm reoxygenation by HBOT can significantly enhance the bactericidal activity of ciprofloxacin on P. aeruginosa. Combining ciprofloxacin treatment with HBOT thus clearly has potential to improve the treatment of P. aeruginosa biofilm infections. Article Published Date : Jan 31, 2016

Abstract Title: The effect of different application timings of hyperbaric oxygen treatment on nerve regeneration in rats. Abstract Source: Microsurgery. 2016 Jan 16. Epub 2016 Jan 16. PMID: 26773276 Abstract Author(s): Bilsev Ince, Abdullah Arslan, Mehmet Dadaci, Pembe Oltulu, Fatma Bilgen Article Affiliation: Bilsev Ince Abstract: BACKGROUND: The aim of the study was to determine the effect of different application timings of hyperbaric oxygen treatment (HBO) on nerve regeneration in rats. MATERIALS AND METHODS: A total of forty 12-week-old female Wistar albino rats were used. The sciatic nerve was transected. The nerve ends were then realigned and repaired using standard microsurgical techniques. Animals were randomly assigned to four groups: 1) No hyperbaric oxygen, sectioned and repaired; 2) HBO started at postoperative first hour, sectioned and repaired; 3) HBO started at postoperative first week, sectioned, and repaired; and 4) HBO started at postoperative second week, sectioned, and repaired. All rats in all groups were evaluated with gait analysis at 8 and 16 weeks postoperatively. Sciatic function index was calculated. Sciatic nerve samples were taken after gait analysis at 16th week. Foreign body reaction, the intensity of the inflammatory cells and types, repair-associated vascular proliferation in the field, axonal vacuolar degeneration of the fibers from the cut line transition density and switching layout, and myelinization density with perineural sheath were evaluated histopathologically. RESULTS: At the 16th week, group 2 demonstrated the best gait analysis results. Gait analysis was better for group 3 than groups 1 and 4 (P < 0.05). No significant differences were observed among the groups in inflammation (P > 0.05). Fibrosis was statistically less in group 2 than that in other groups (P < 0.05); however, no significant differences were observed among groups 1, 3, and 4 (P > 0.05). CONCLUSIONS: Our results suggest that initiating HBO early after nerve repair will make a positive impact on recovery.© 2016 Wiley Periodicals, Inc. Microsurgery, 2016. Article Published Date : Jan 15, 2016

Abstract Title: Outcomes of Radiation Injuries Using Hyperbaric Oxygen Therapy: An Observational Cohort Study. Abstract Source: Adv Skin Wound Care. 2016 Jan ;29(1):12-19. PMID: 26650092 Abstract Author(s): Jeffrey A Niezgoda, Thomas E Serena, Marissa J Carter Article Affiliation: Jeffrey A Niezgoda Abstract: BACKGROUND: The late effects of radiation therapy following the treatment of cancer are a well-known consequence. Evidence increasingly supports the use of hyperbaric oxygen (HBO) as an adjunctive treatment in a variety of radiation injuries. OBJECTIVE: To present the findings of a new registry of radiation injuries that was developed to evaluate the outcomes and treatment parameters of HBO treatment (HBOT) when applied to patients experiencing the late effects of radiation therapy. DESIGN: Observational cohort. SETTING: Hyperbaric oxygen clinical treatment facilities in the United States. PATIENTS: A total of 2538 patients with radiation-induced injuries. MEASUREMENTS: Injury type, patient age, gender, diabetes, end-stage renal disease, collagen vascular disease, coronary artery disease/peripheral vascular disease, on anticoagulant medication, on systemic steroid medication, patient is current smoker, patient abuses alcohol, symptoms reported, duration of symptoms, symptom progression prior to HBOT, transfusion units, HBOT time, HBOT count, HBO chamber pressure, HBO time in chamber, and patient outcomes. RESULTS: A total of 2538 patient entries with 10 types of radiation injuries were analyzed. The 5 most common injuries were osteoradionecrosis (33.4%), dermal soft tissue radionecrosis (27.5%), radiation cystitis (18.6%), radiation proctitis (9.2%), and laryngeal radionecrosis (4.8%). Clinical outcomes following HBOT were positive with symptoms that improved or resolved varying from 76.7% to 92.6%, depending on injury type. Overall, although the mean symptom improvement score between some groups is statistically significant, the differences are probably not clinically meaningful. Patients with osteoradionecrosis had the highest mean symptom improvement score (3.24) compared with a mean of 3.04 for laryngeal radionecrosis. LIMITATIONS: Limited data were available on patient comorbidities and symptom severity. CONCLUSIONS: Outcomes from a large patient registry of radiation-induced injuries support the continued therapeutic use of HBOT for radiation injuries. Article Published Date : Dec 31, 2015

Abstract Title: Effects of hyperbaric oxygen on the Nrf2 signaling pathway in secondary injury following traumatic brain injury. Abstract Source: Genet Mol Res. 2016 ;15(1). Epub 2016 Jan 29. PMID: 26909929 Abstract Author(s): X E Meng, Y Zhang, N Li, D F Fan, C Yang, H Li, D Z Guo, S Y Pan Article Affiliation: X E Meng Abstract: We investigated the effects of hyperbaric oxygen treatment on the Nrf2 signaling pathway in secondary injury following traumatic brain injury, using a rat model. An improved Feeney freefall method was used to establish the rat traumatic brain injury model. Sixty rats were randomly divided into three groups: a sham surgery group, a traumatic brain injury group, and a group receiving hyperbaric oxygen treatment after traumatic brain injury. Neurological function scores were assessed at 12 and 24 h after injury. The expression levels of Nrf2, heme oxygenase 1 (HO-1), and quinine oxidoreductase 1 (NQO-1) in the cortex surrounding the brain lesion were detected by western blotting 24 h after the injury. Additionally, the TUNEL method was used to detect apoptosis of nerve cells 24 h after traumatic injury and Nissl staining was used to detect the number of whole neurons. Hyperbaric oxygen treatment significantly increased the expression of nuclear Nrf2 protein (P<0.05), HO-1, and NQO-1 in the brain tissues surrounding the lesion after a traumatic brain injury (P<0.05) and also significantly reduced the number of apoptotic and injured nerve cells. The neurological function scores also improved with hyperbaric oxygen treatment (P<0.05). Therefore, hyperbaric oxygen has a neuroprotective role in traumatic brain injury, which is mediated by up-regulation of the Nrf2 signaling pathway. Article Published Date : Dec 31, 2015

Abstract Title: Anti-Inflammatory Effects of Hyperbaric Oxygenation during DSS-Induced Colitis in BALB/c Mice Include Changes in Gene Expression of HIF-1α, Proinflammatory Cytokines, and Antioxidative Enzymes. Abstract Source: Mediators Inflamm. 2016;2016:7141430. Epub 2016 Aug 30. PMID: 27656047 Abstract Author(s): Sanja Novak, Ines Drenjancevic, Rosemary Vukovic, Zoltán Kellermayer, Anita Cosic, Maja Tolusic Levak, Péter Balogh, Filip Culo, Martina Mihalj Article Affiliation: Sanja Novak Abstract: Reactive oxygen species (ROS) and nitrogen species have an indispensable role in regulating cell signalling pathways, including transcriptional control via hypoxia inducible factor-1α (HIF-1α). Hyperbaric oxygenation treatment (HBO2) increases tissue oxygen content and leads to enhanced ROS production. In the present study DSS-induced colitis has been employed in BALB/c mice as an experimental model of gut mucosa inflammation to investigate the effects of HBO2 on HIF-1α, antioxidative enzyme, and proinflammatory cytokine genes during the colonic inflammation. Here we report that HBO2 significantly reduces severity of DSS-induced colitis, as evidenced by the clinical features, histological assessment, impaired immune cell expansion and mobilization, and reversal of IL-1β, IL-2, and IL-6 gene expression. Gene expression and antioxidative enzyme activity were changed by the HBO2 and the inflammatory microenvironment in the gut mucosa. Strong correlation of HIF-1α mRNA level to GPx1, SOD1, and IL-6 mRNA expression suggests involvement of HIF-1α in transcriptionalregulation of these genes during colonic inflammation and HBO2. This is further confirmed by a strong correlation of HIF-1α with known target genes VEGF and PGK1. Results demonstrate that HBO2 has an anti-inflammatory effect in DSS-induced colitis in mice, and this effect is at least partly dependent on expression of HIF-1α and antioxidative genes. Article Published Date : Dec 31, 2015

Abstract Title: The Efficacy of Hyperbaric Oxygen Therapy on Middle Cerebral Artery Occlusion in Animal Studies: A Meta-Analysis. Abstract Source: PLoS One. 2016 ;11(2):e0148324. Epub 2016 Feb 9. PMID: 26859390 Abstract Author(s): Yang Xu, Renjie Ji, Ruili Wei, Bo Yin, Fangping He, Benyan Luo Article Affiliation: Yang Xu Abstract: BACKGROUND: Inconsistent results have been reported for hyperbaric oxygen therapy (HBO) for acute stroke. We conducted a systematic review and meta-analysis to evaluate the benefit of HBO in animal studies of middle cerebral artery occlusion (MCAO). METHODS: A systematic search of the literature published prior to September 2015 was performed using Embase, Medline (OvidSP), Web of Science and PubMed. Keywords included"hyperoxia"OR"hyperbaric oxygen"OR"HBO"AND"isch(a)emia"OR"focal cerebral ischemia"OR"stroke"OR"infarct"OR"middle cerebral artery occlusion (MCAO)."The primary endpoints were the infarct size and/or neurological outcome score evaluated after HBO treatment in MCAO. Heterogeneity was analyzed using Cochrane Library's RevMan 5.3.5. RESULTS: Fifty-one studies that met the inclusion criteria were identified among the 1198 studies examined. When compared with control group data, HBO therapy resulted in infarct size reduction or improved neurological function (32% decrease in infarct size; 95% confidence interval (CI), range 28%-37%; p<0.00001). Mortality was 18.4% in the HBO group and 26.7% in the control group (RR 0.72, 95% CI, 0.54-0.98; p = 0.03). Subgroup analysis showed that a maximal neuro-protective effect was reached when HBO was administered immediately after MCAO with an absolute atmospheric pressure (ATA) of 2.0 (50% decrease; 95% CI, 43% -57% decrease; p<0.0001) and more than 6 hours HBO treatment (53% decrease; 95% CI, 41% -64% decrease; p = 0.0005). CONCLUSIONS: HBO had a neuro-protective effect and improved survival in animal models of MCAO, especially in animals given more than 6 hours of HBO and when given immediately after MCAO with 2.0 ATA. Article Published Date : Dec 31, 2015

Abstract Title: Hyperbaric Oxygen Therapy: A New Treatment for Chronic Pain? Abstract Source: Pain Pract. 2016 06 ;16(5):620-8. Epub 2015 May 19. PMID: 25988526 Abstract Author(s): Ainsley M Sutherland, Hance A Clarke, Joel Katz, Rita Katznelson Article Affiliation: Ainsley M Sutherland Abstract: BACKGROUND AND OBJECTIVE: Hyperbaric oxygen therapy (HBOT) is a treatment providing 100% oxygen at a pressure greater than that at sea level. HBOT is becoming increasingly recognized as a potential treatment modality for a broad range of ailments, including chronic pain. In this narrative review, we discuss the current understanding of pathophysiology of nociceptive, inflammatory and neuropathic pain, and the body of animal studies addressing mechanisms by which HBOT may ameliorate these different types of pain. Finally, we review clinical studies suggesting that HBOT may be useful in treating chronic pain syndromes, including chronic headache, fibromyalgia, complex regional pain syndrome, and trigeminal neuralgia. DATABASE AND DATA TREATMENT: A comprehensive search through MEDLINE, EMBASE, Scopus, and Web of Science for studies relating to HBOT and pain was performed using the following keywords: hyperbaric oxygen therapy or hyperbaric oxygen treatment (HBOT), nociceptive pain, inflammatory pain, neuropathic pain, HBOT AND pain, HBOT AND headache, HBOT AND fibromyalgia, HBOT AND complex regional pain syndrome, and HBOT AND trigeminal neuralgia. RESULTS: Twenty-five studies examining the role of HBOT in animal models of pain and human clinical trials were found and reviewed for this narrative review. CONCLUSIONS: HBOT has been shown to reduce pain using animal models. Early clinical research indicates HBOT may also be useful in modulating human pain; however, further studies are required to determine whether HBOT is a safe and efficacious treatment modality for chronic pain conditions. Article Published Date : Dec 31, 2015

Abstract Title: Hyperbaric oxygen therapy for late radiation tissue injury. Abstract Source: Cochrane Database Syst Rev. 2016 ;4:CD005005. Epub 2016 Apr 28. PMID: 27123955 Abstract Author(s): Michael H Bennett, John Feldmeier, Neil B Hampson, Robert Smee, Christopher Milross Article Affiliation: Michael H Bennett Abstract: BACKGROUND: Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of people having radiotherapy will be long-term survivors. Some will experience late radiation tissue injury (LRTI) developing months or years later. Hyperbaric oxygen therapy (HBOT) has been suggested as a treatment for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery. OBJECTIVES: To assess the benefits and harms of HBOT for treating or preventing LRTI. SEARCH METHODS: We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 11), MEDLINE, EMBASE, DORCTIHM and reference lists of articles in December 2015. We also searched for ongoing trials at clinicaltrials.gov. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing the effect of HBOT versus no HBOT on LRTI prevention or healing. DATA COLLECTION AND ANALYSIS: Three review authors independently evaluated the quality of the relevant trials using the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and extracted the data from the included trials. MAIN RESULTS: Fourteen trials contributed to this review (753 participants). There was some moderate quality evidence that HBOT was more likely to achieve mucosal coverage with osteoradionecrosis (ORN) (risk ratio (RR) 1.3; 95% confidence interval (CI) 1.1 to 1.6, P value = 0.003, number needed to treat for an additional beneficial outcome (NNTB) 5; 246 participants, 3 studies). There was also moderate quality evidence of a significantly improved chance of wound breakdown without HBOT following operative treatment for ORN (RR 4.2; 95% CI 1.1 to 16.8, P value = 0.04, NNTB 4; 264 participants, 2 studies). From single studies there was a significantly increased chance of improvement or cure following HBOT for radiation proctitis (RR 1.72; 95% CI 1.0 to 2.9, P value = 0.04, NNTB 5), and following both surgical flaps (RR 8.7; 95% CI 2.7 to 27.5, P value = 0.0002, NNTB 4) and hemimandibulectomy (RR 1.4; 95% CI 1.1 to 1.8, P value = 0.001, NNTB 5). There was also a significantly improved probability of healing irradiated tooth sockets following dental extraction (RR 1.4; 95% CI 1.1 to 1.7, P value = 0.009, NNTB 4).There was no evidence of benefit in clinical outcomes with established radiation injury to neural tissue, and no randomised data reported on the use of HBOT to treat other manifestations of LRTI. These trials did not report adverse events. AUTHORS' CONCLUSIONS: These small trials suggest that for people with LRTI affecting tissues of the head, neck, anus and rectum, HBOT is associated with improved outcome. HBOT also appears to reduce the chance of ORN following tooth extraction in an irradiated field. There was no such evidence of any important clinical effect on neurological tissues. The application of HBOT to selected participants and tissues may be justified. Further research is required to establish the optimum participant selection and timing of any therapy. An economic evaluation should be undertaken. Article Published Date : Dec 31, 2015

Abstract Title: Hyperbaric oxygen therapy in treating post-ischemic pain caused by polycythemia vera complications: a case report. Abstract Source: Undersea Hyperb Med. 2015 Nov-Dec;42(6):607-11. PMID: 26742260 Abstract Author(s): Mirna Zulec, Aleksandra Volf, Zrinka Puharić Article Affiliation: Mirna Zulec Abstract: One of the complications of polycythemia vera (PV) can be acute thrombotic occlusion. The severity and prolonged duration of this condition can lead to nerve damage. In this case a 34-year-old male had thrombotic occlusions of the popliteal artery, resulting in chronic limb ischemia, which was treated with thrombectomy and amputation of one digit. The administered therapy consisted of hydroxyurea, analgesics, antidepressants and acetylsalicylic acid. When the patient was admitted he suffered from ischemic pain, he had developed an ulcer on his big toe and he was emotionally unstable, with suicidal thoughts. The patient was treated with 14 hyperbaric oxygen (HBO2) treatments in total. There was evident paint relief after four treatments and healing of the ulcerous tissue after three weeks. During the patient's medical examination eight months after the treatment, his condition was still satisfactory, with no presence of pain, ulcer or signs of depression, and with no changes in hemodynamics. This case provides additional evidence to the data for HBO2 use in ischemic pain management. Article Published Date : Oct 31, 2015

Abstract Title: Hyperbaric oxygen therapy for refractory radiation-induced hemorrhagic cystitis. Abstract Source: Int J Urol. 2015 Oct ;22(10):962-6. Epub 2015 Jul 5. PMID: 26146963 Abstract Author(s): Tiago M Ribeiro de Oliveira, António J Carmelo Romão, Francisco M Gamito Guerreiro, Tomé M Matos Lopes Article Affiliation: Tiago M Ribeiro de Oliveira Abstract: OBJECTIVES: To analyze the efficacy of hyperbaric oxygen for the treatment of radiation-induced hemorrhagic cystitis and to identify factors associated with successful treatment. METHODS: Clinical records from 176 patients with refractory radiation-induced hemorrhagic cystitis treated at the Portuguese Navy Center for Underwater and Hyperbaric Medicine, during a 15-year period, were retrospectively analyzed. Evolution of macroscopic hematuria was used to analyze treatment efficacy and correlated with other external variables. RESULTS: From a total of 176 treated patients, 23.9% evidenced other radiation-induced soft tissue lesions. After an average on 37 sessions, 89.8% of patients showed resolution of hematuria, with only 1.7% of adverse events. In our sample, hematuria resolution after treatment with hyperbaric oxygen was statistically associated to the need for transfusion therapy (P = 0.026) and the number of sessions of hyperbaric oxygen (P = 0.042). No relationship was found with the remaining variables. CONCLUSIONS: Refractory radiation-induced hemorrhagic cystitis can be successfully and safely treated with hyperbaric oxygen. Treatment effectiveness seems to be correlated with the need for transfusion therapy and the number of sessions performed. Article Published Date : Sep 30, 2015

Abstract Title: Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model. Abstract Source: Braz J Cardiovasc Surg. 2015 Oct ;30(5):538-43. PMID: 26735600 Abstract Author(s): Tolga Kurt, Ahmet Vural, Ahmet Temiz, Ersan Ozbudak, Ali Umit Yener, Suzan Sacar, Mustafa Sacar Article Affiliation: Tolga Kurt Abstract: OBJECTIVE: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. METHODS: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. RESULTS: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). CONCLUSION: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects. Article Published Date : Sep 30, 2015

Abstract Title: [HYPERBARIC OXYGEN THERAPY IN THE TREATMENT OF MALE INFERTILITY ASSOCIATED WITH INCREASED SPERM DNA FRAGMENTATION AND REACTIVE OXYGEN SPECIES IN SEMEN]. Abstract Source: Urologiia. 2015 Sep-Oct(5):74-6. PMID: 26859943 Abstract Author(s): A Yu Metelev, A B Bogdanov, E V Ivkinl, A A Mitrokhin, M M Vodneva, E I Veliev Article Affiliation: A Yu Metelev Abstract: The aim of this study was to explore the potential of hyperbaric oxygenation (HBO) for reduction of sperm DNA fragmentation level and reactive oxygen species (ROS) in semen. The study included 90 men with idiopathic infertility. Patients of the treatment group (n = 60) underwent HBO before the vitro fertilization (IVF) procedure. In the control group (n = 30) IVF was carried out without prior cours of HBO. Sperm DNA fragmentation analysis was carried out using the TUNEL assay, the level of ROS in the ejaculate was measured by chemiluminescence. HBO treatment resulted in a significant decrease in the mean level of sperm DNA fragmentation from 33.2± 7.5 to 11.9 ± 5.9%, and the median ROS in sperm from 0.89 to 0.39 mV/s (p<0.05). In the control group these changes were not statistically significant. Pregnancy after IVF occurred in 63.3% (38/60) of sexual partners of the treatment group men and in 36.7% (11/30) of the control group (p<0.05). The high efficiency of HBO in overcoming the adverse effects of oxidative stress on sperm parameters allows us to consider it as a promising method for the treatment of men with idiopathic infertility. Article Published Date : Aug 31, 2015

Abstract Title: Hyperbaric oxygen therapy for the treatment of radiation-induced xerostomia: a systematic review. Abstract Source: Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jul ;120(1):22-8. Epub 2015 Mar 25. PMID: 26093680 Abstract Author(s): Nyssa F Fox, Christopher Xiao, Amit J Sood, Tiffany L Lovelace, Shaun A Nguyen, Anand Sharma, Terry A Day Article Affiliation: Nyssa F Fox Abstract: OBJECTIVE: Radiation-induced xerostomia is one of the most common morbidities of radiation therapy in patients with head and neck cancer. However, in spite of its high rate of occurrence, there are few effective therapies available for its management. The aim of this study was to assess the efficacy of hyperbaric oxygen on the treatment of radiation-induced xerostomia and xerostomia-related quality of life. STUDY DESIGN: PubMed, Google Scholar, and the Cochrane Library were searched for retrospective or prospective trials assessing subjective xerostomia, objective xerostomia, or xerostomia-related quality of life. To be included, patients had to have received radiation therapy for head and neck cancer, but not hyperbaric oxygen therapy (HBOT). RESULTS: The systematic review initially identified 293 potential articles. Seven studies, comprising 246 patients, qualified for inclusion. Of the included studies, 6 of 7 were prospective in nature, and 1 was a retrospective study; and 2 of the 7 were controlled studies. CONCLUSIONS: HBOT may have utility for treating radiation-induced xerostomia refractory to other therapies. Additionally, HBOT may induce long-term improvement in subjective assessments of xerostomia, whereas other therapies currently available only provide short-term relief. The strength of these conclusions is limited by the lack of randomized controlled clinical trials. Article Published Date : Jun 30, 2015

Abstract Title: Efficacy of hyperbaric oxygen therapy combined with mild hyperthermia for improving the anti-tumour effects of carboplatin. Abstract Source: Int J Hyperthermia. 2015 ;31(6):643-8. Epub 2015 Jul 9. PMID: 26156211 Abstract Author(s): Takayuki Ohguri, Naoki Kunugita, Katsuya Yahara, Hajime Imada, Hidehiko Uemura, Nadayoshi Shinya, Gotou Youjirou, Chijiwa Takashi, Ryuji Okazaki, Akira Ootsuyama, Yukunori Korogi Article Affiliation: Takayuki Ohguri Abstract: PURPOSE: The aim of this study was to evaluate the effects of hyperbaric oxygen therapy (HBO) on the enhancement of hyperthermic chemosensitisation to carboplatin at mild temperatures in experimental tumours. METHODS: SCCVII carcinoma in C3H/He mice was used to assess tumour growth delay. The mice received intraperitoneal injections of carboplatin. For HBO treatment, the mice were exposed to HBO at 2.0 atmospheres of absolute oxygen for 60 min. For mild hyperthermia (HT), treatment at 41.5 °C for 30 min was performed. The tumour tissue pO2 levels were measured with a digital pO2 monitor during and immediately after treatment. RESULTS: The average time taken to reach a threefold relative tumour size was significantly longer after treatment with carboplatin combined with mild HT and HBO than after treatment with carboplatin and mild HT. The relative sizes of the tumours after the combined treatment were smallest when the treatment sequence was carboplatin, mild HT, and HBO. The tumour tissue pO2 values were significantly higher immediately after mild HT followed by HBO than immediately after HBO followed by mild HT. The tumour tissue pO2 levels during mild HT and HBO generally increased, although the patterns of the increases varied. CONCLUSION: The administration of HBO increased the effects of hyperthermic chemosensitisation to carboplatin at mild temperatures on experimental tumours, particularly when given in the sequence of carboplatin, mild HT, and HBO, a finding that supports previous clinical outcomes for a novel combined therapy using carboplatin plus HT and HBO. Article Published Date : Dec 31, 2014

Abstract Title: Hyperbaric oxygen therapy can diminish fibromyalgia syndrome - prospective clinical trial. Abstract Source: PLoS One. 2015 ;10(5):e0127012. Epub 2015 May 26. PMID: 26010952 Abstract Author(s): Shai Efrati, Haim Golan, Yair Bechor, Yifat Faran, Shir Daphna-Tekoah, Gal Sekler, Gregori Fishlev, Jacob N Ablin, Jacob Bergan, Olga Volkov, Mony Friedman, Eshel Ben-Jacob, Dan Buskila Article Affiliation: Shai Efrati Abstract: BACKGROUND: Fibromyalgia Syndrome (FMS) is a persistent and debilitating disorder estimated to impair the quality of life of 2-4% of the population, with 9:1 female-to-male incidence ratio. FMS is an important representative example of central nervous system sensitization and is associated with abnormal brain activity. Key symptoms include chronic widespread pain, allodynia and diffuse tenderness, along with fatigue and sleep disturbance. The syndrome is still elusive and refractory. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in FMS. METHODS AND FINDINGS: A prospective, active control, crossover clinical trial. Patients were randomly assigned to treated and crossover groups: The treated group patients were evaluated at baseline and after HBOT. Patients in the crossover-control group were evaluated three times: baseline, after a control period of no treatment, and after HBOT. Evaluations consisted of physical examination, including tender point count and pain threshold, extensive evaluation of quality of life, and single photon emission computed tomography (SPECT) imaging for evaluation of brain activity. The HBOT protocol comprised 40 sessions, 5 days/week, 90 minutes, 100% oxygen at 2ATA. Sixty female patients were included, aged 21-67 years and diagnosed with FMS at least 2 years earlier. HBOT in both groups led to significant amelioration of all FMS symptoms, with significant improvement in life quality. Analysis of SPECT imaging revealed rectification of the abnormal brain activity: decrease of the hyperactivity mainly in the posterior region and elevation of the reduced activity mainly in frontal areas. No improvement in any of the parameters was observed following the control period. CONCLUSIONS: The study provides evidence that HBOT can improve the symptoms and life quality of FMS patients. Moreover, it shows that HBOT can induce neuroplasticity and significantly rectify abnormal brain activity in pain related areas of FMS patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT01827683. Article Published Date : Dec 31, 2014

Abstract Title: A Multidisciplinary Approach with Hyperbaric Oxygen Therapy Improve Outcome in Snake Bite Injuries. Abstract Source: Toxicol Int. 2015 Jan-Apr;22(1):104-9. PMID: 26862269 Abstract Author(s): Pradeoth Mukundan Korambayil, Prashanth Varkey Ambookan, Siju Varghese Abraham, Ajay Ambalakat Article Affiliation: Pradeoth Mukundan Korambayil Abstract: AIM: Snakebite injuries are common in tropical India among those who are involved in outdoor activities. These injuries results in cellulitis, gangrene at the bite area, bleeding manifestations, compartment syndrome, regional lymphadenopathy, septicemia, hypotension, and disseminated intravascular coagulation (DIC) resulting in significant morbidity and mortality. The purpose of this study is to share our experience of multidisciplinary approach in the management of snakebite injuries of the extremities with various treatment modalities including hyperbaric oxygen (HBO) therapy, surgical debridement, and soft tissue reconstruction to provide an effective treatment for snake bite injuries. METHODS: The study was conducted in the Department of Plastic Surgery, during the period October 2012-December 2014, wherein all the patients who were admitted with snakebite injuries were enrolled and the patients treated in plastic surgery department were included into the study. Out of total 766 patients, there were 323 patients treated with anti snake venom (ASV) and 29 died among the treated patients; 205 patients belonged to pediatric age group. RESULTS: Out of 112 patients referred to Department of Plastic Surgery, 50 cases presented with cellulitis, 24 patients with compartment syndrome, and 38 patients were referred for the management of soft tissue cover over the extremities. Among 112 patients, 77 involved the lower extremity and 35 the upper extremity. CONCLUSION: Multidisciplinary approach including hyperbaric oxygen (HBO) therapy improves outcome in the management of snakebite injuries of the extremities. Article Published Date : Dec 31, 2014

Abstract Title: Effect of hyperbaric oxygen treatment in a rat model of abdominal aortic aneurysm. Abstract Source: Undersea Hyperb Med. 2014 Jan-Feb;41(1):9-15. PMID: 24649712 Abstract Author(s): Murat Yalcin, Omer Yiğiner, Murat Eroğlu, Ozer Sehirli, Ufuk Berber, Fatih Ozçelik, Göksel Sener Article Affiliation: Murat Yalcin Abstract: Matrix metalloproteinase (MMP) plays a pivotal role in the pathophysiology of abdominal aortic aneurysms (AAA). Experimental studies have demonstrated that hyperbaric oxygen (HBO2) therapy decreases MMP levels in different tissues. However, the effect of HBO2 therapy on AAA has yet to be investigated. This study aimed to examine the effects of HBO2 on MMPs in an experimental AAA model. The model was implemented with CaCl2 in 12-week-old male Wistar albino rats. The rats were randomized into four groups: Group I: received NaCl (n = 6) (Sham group); Group II: received NaCl and were treated with HBO2 (n = 6); Group III: received CaCl2 (n = 6); and Group IV: received CaCl2 and were treated with HBO2 (n = 6). HBO2 therapy was applied for five of seven days over a period of six weeks. Although in the CaCl2 groups, aortic diameters were significantly higher than the NaCl groups (p<0.05), there was no difference between pre- and post-HBO2 in the CaCl2 groups (p>0.05). In the CaCl2 group, the MMP-2 and MMP-9 levels were significantly higher than those in the NaCl group (p<0.05). HBO2 therapy had no statistically significant effect on the MMP-2 and MMP-9 levels in Groups III and IV. However, it was observed that both levels clearly decreased in Group IV. In conclusion, the study suggested that HBO2 may have favorable effects on MMP levels. Article Published Date : Dec 31, 2013

Abstract Title: Effects of hyperbaric oxygen on proliferation and differentiation of osteoblasts from human alveolar bone. Abstract Source: Langenbecks Arch Surg. 2011 Apr 14. Epub 2011 Apr 14. PMID: 17653977 Abstract Author(s): Dong Wu, Jos Malda, Ross Crawford, Yin Xiao Abstract: In view of the controversy of the clinical use of hyperbaric oxygen (HBO) treatment to stimulate fracture healing and bone regeneration, we have analyzed the effects of daily exposure to HBO on the proliferation and differentiation of human osteoblasts in vitro. HBO stimulated proliferation when osteoblasts were cultured in 10% fetal calf serum (FCS), whereas an inhibitory effect of HBO was observed when cultures were supplemented with 2% FCS. On the other hand, HBO enhanced biomineralization with an increase in bone nodule formation, calcium deposition, and alkaline phosphatase activity, whereas no cytotoxic effect was detected using a lactate dehydrogenase activity assay. The data suggest that the exposure of osteoblasts to HBO enhances differentiation toward the osteogenic phenotype, providing cellular evidence of the potential application of HBO in fracture healing and bone regeneration. Article Published Date : Apr 14, 2011

Abstract Title: The effect of hyperbaric oxygen on clinical outcome of patients after resection of meningiomas with conspicuous peritumoral brain edema. Abstract Source: Undersea Hyperb Med. 2011 Mar-Apr;38(2):109-15. PMID: 21510270 Abstract Author(s): Xiaoping Tang, Xiaohong Yin, Tao Zhang, Hua Peng Article Affiliation: Department of Neurosurgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: The goal of this study was to determine the effect of hyperbaric oxygen therapy on the clinical outcome of patients after resection of meningiomas with conspicuous peritumoral brain edema (PTBE). PATIENTS AND METHODS: 232 patients with intracranial meningiomas and conspicuous PTBE were allocated to the HBO2 Group or the Control Group (116 in each group). The Karnofsky Performance Score (KPS), the focal brain edema and the encephalomalacia in the operative region, as well as the number of patients with neurological deficits were compared statistically between the two groups at different times after the operation. RESULTS: On the third day after operation, the KPS and focal brain edema in the operative region between the HBO2 Group and the Control Group were not significantly different (p>0.05), but 15 days after surgery, compared with the Control Group, the KPS of the HBO2 Group appeared obviously higher (p<0.05), and the focal brain edema in the operative region was definitely smaller (p<0.05). Six months after surgery, the volume of encephalomalacia in operative region and the number of patients with neurological deficits in the HBO2 Group were significantly less than those in the Control Group (p<0.05). CONCLUSION: HBO2 therapy is effective in reducing edema formation and neurological deficits after resection of meningiomas with conspicuous PTBE. Article Published Date : Mar 01, 2011

Abstract Title: Refractory vasculitic ulcer of the toe in an adolescent suffering from systemic lupus erythematosus treated successfully with hyperbaric oxygen therapy. Abstract Source: Ital J Pediatr. 2010 Oct 31;36(1):72. Epub 2010 Oct 31. PMID: 21040521 Abstract Author(s): Alma N Olivieri, Antonio Mellos, Carlo Duilio, Milena Di Meglio, Angela Mauro, Laura Perrone Abstract: ABSTRACT: Skin ulcers are a dangerous and uncommon complication of vasculitis. We describe the case of a teenager suffering from Systemic Lupus Erythematosus with digital ulcer resistant to conventional therapy, treated successfully with hyperbaric oxygen therapy. The application of hyperbaric oxygen, which is used for the treatment of ischemic ulcers, is an effective and safe therapeutic option in patients with ischemic vasculitic ulcers in combination with immunosuppressive drugs. Further studies are needed to evaluate its role as primary therapy for this group of patients. Article Published Date : Oct 31, 2010

Abstract Title: A metaanalysis of the effectiveness and safety of ozone treatments for herniated lumbar discs. Abstract Source: J Vasc Interv Radiol. 2010 Apr;21(4):534-48. Epub 2010 Feb 25. PMID: 20188591 Abstract Author(s): Jim Steppan, Thomas Meaders, Mario Muto, Kieran J Murphy Article Affiliation: ActiveO, Salt Lake City, Utah, USA. Abstract: PURPOSE: To determine statistically significant effects of oxygen/ozone treatment of herniated discs with respect to pain, function, and complication rate. MATERIALS AND METHODS: Random-effects metaanalyses were used to estimate outcomes for oxygen/ozone treatment of herniated discs. A literature search provided relevant studies that were weighted by a study quality score. Separate metaanalyses were performed for visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcome scales, as well as for complication rate. Institutional review board approval was not required for this retrospective analysis. RESULTS: Twelve studies were included in the metaanalyses. The inclusion/exclusion criteria, patient demographics, clinical trial rankings, treatment procedures, outcome measures, and complications are summarized. Metaanalyses were performed on the oxygen/ozone treatment results for almost 8,000 patients from multiple centers. The mean improvement was 3.9 for VAS and 25.7 for ODI. The likelihood of showing improvement on the modified MacNab scale was 79.7%. The means for the VAS and ODI outcomes are well above the minimum clinically important difference and the minimum (significant) detectable change. The likelihood of complications was 0.064%. CONCLUSIONS: Oxygen/ozone treatment of herniated discs is an effective and extremely safe procedure. The estimated improvement in pain and function is impressive in view of the broad inclusion criteria, which included patients ranging in age from 13 to 94 years with all types of disc herniations. Pain and function outcomes are similar to the outcomes for lumbar discs treated with surgical discectomy, but the complication rate is much lower (<0.1%) and the recovery time is significantly shorter. Article Published Date : Apr 01, 2010

Abstract Title: Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndrome. Abstract Source: Evid Based Complement Alternat Med. 2009 Dec 17. Epub 2009 Dec 17. PMID: 15174218 Abstract Author(s): M Z Kiralp, S Yildiz, D Vural, I Keskin, H Ay, H Dursun Article Affiliation: Department of Physical Therapy and Rehabilitation, Gülhane Military Medical Academy, Haydarpaşa Training Hospital, Istanbul, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: In this double-blind, randomized, placebo-controlled study we aimed to assess the effectiveness of hyperbaric oxygen (HBO) therapy for treating patients with complex regional pain syndrome (CRPS). Of the 71 patients, 37 were allocated to the HBO group and 34 to the control (normal air) group. Both groups received 15 therapy sessions in a hyperbaric chamber. Pain, oedema and range of motion (ROM) of the wrist were evaluated before treatment, after the 15th treatment session and on day 45. In the HBO group there was a significant decrease in pain and oedema and a significant increase in the ROM of the wrist. When we compared the two groups, the HBO group had significantly better results with the exception of wrist extension. In conclusion, HBO is an effective and well-tolerated method for decreasing pain and oedema and increasing the ROM in patients with CRPS. Article Published Date : Dec 17, 2009

Abstract Title: Hyperbaric oxygen as a chemotherapy adjuvant in the treatment of osteosarcoma. Abstract Source: Oncol Rep. 2009 Nov;22(5):1045-50. PMID: 19787219 Abstract Author(s): Yasuomi Kawasoe, Masahiro Yokouchi, Yoshinori Ueno, Hiroaki Iwaya, Hiroki Yoshida, Setsuro Komiya Article Affiliation: Department of Orthopaedic Surgery, Kagoshima Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan. Abstract: Although hyperbaric oxygen has been shown to enhance the efficacy of radiotherapy and chemotherapy for the treatment of several malignant tumors, the impact of hyperbaric oxygen on osteosarcoma has not yet been demonstrated. In this study, we investigated the efficacy of hyperbaric oxygen alone and in combination with an anti-cancer drug as an adjuvant to chemotherapy. In vitro, highly metastatic murine osteosarcoma cell lines were exposed to hyperbaric oxygen and cell viability was examined. Hyperbaric oxygen alone significantly suppressed cell proliferation, and hyperbaric oxygen plus carboplatin exhibited significant synergism in suppression of cell proliferation. In vivo, C3H mice were subcutaneously inoculated with osteosarcoma cells and divided into four groups: control, hyperbaric oxygen, carboplatin, and carboplatin plus hyperbaric oxygen. After 5 weeks, increase in both tumor volume and number of lung metastases was significantly suppressed in the hyperbaric oxygen group. Concomitant hyperbaric oxygen clearly enhanced the chemotherapeutic effects of carboplatin on both tumor growth and lung metastasis in osteosarcoma-bearing mice. Moreover, mortality in the carboplatin plus hyperbaric oxygen group was significantly lower than in the other three groups. These findings suggest that hyperbaric oxygen plus carboplatin combination therapy could be an appropriate therapeutic regimen for the treatment of patients with osteosarcoma. Article Published Date : Nov 01, 2009

Abstract Title: Effect of hyperbaric oxygen therapy on the duration of treatment of spinal tuberculosis. Abstract Source: J Clin Neurosci. 2009 Oct 15. PMID: 19836957 Abstract Author(s): Kivanç Topuz, Ahmet Murat Kutlay, Hakan Simşek, Ahmet Colak, Serdar Kaya, Mehmet Nusret Demircan Abstract: The aim of this retrospective study was to investigate the effect of adjuvant hyperbaric oxygen (HBO) therapy on the duration of antibiotic treatment and rate of radiological improvement in the management of spinal tuberculosis. We reviewed a total of 51 patients with tuberculous spondylitis of the spine who were treated by percutaneous abscess drainage or radical surgical debridement with chemotherapy, and of whom 16 randomly selected patients also received adjuvant HBO therapy and 35 did not. Serological markers were monitored in the course of treatment. Percutaneous needle biopsy was performed on each patient before treatment. Spine and chest radiographs, CT scans and MRI were performed. Infection control was achieved in all patients and no recurrence occured. To our knowledge this is the first reported series of patients with spinal tuberculosis treated with HBO therapy as an adjunct to antituberculous chemotherapy. This combination provided earlier clinical and radiologic improvement than chemotherapy alone. Article Published Date : Oct 15, 2009

Abstract Title: Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial. Abstract Source: BMC Pediatr. 2009 Mar 13;9:21. PMID: 19284641 Abstract Author(s): Daniel A Rossignol, Lanier W Rossignol, Scott Smith, Cindy Schneider, Sally Logerquist, Anju Usman, Jim Neubrander, Eric M Madren, Gregg Hintz, Barry Grushkin, Elizabeth A Mumper Abstract: BACKGROUND: Several uncontrolled studies of hyperbaric treatment in children with autism have reported clinical improvements; however, this treatment has not been evaluated to date with a controlled study. We performed a multicenter, randomized, double-blind, controlled trial to assess the efficacy of hyperbaric treatment in children with autism. METHODS: 62 children with autism recruited from 6 centers, ages 2-7 years (mean 4.92 +/- 1.21), were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm) and 24% oxygen ("treatment group", n = 33) or slightly pressurized room air at 1.03 atm and 21% oxygen ("control group", n = 29). Outcome measures included Clinical Global Impression (CGI) scale, Aberrant Behavior Checklist (ABC), and Autism Treatment Evaluation Checklist (ATEC). RESULTS: After 40 sessions, mean physician CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0008), receptive language (p < 0.0001), social interaction (p = 0.0473), and eye contact (p = 0.0102); 9/30 children (30%) in the treatment group were rated as "very much improved" or "much improved" compared to 2/26 (8%) of controls (p = 0.0471); 24/30 (80%) in the treatment group improved compared to 10/26 (38%) of controls (p = 0.0024). Mean parental CGI scores significantly improved in the treatment group compared to controls in overall functioning (p = 0.0336), receptive language (p = 0.0168), and eye contact (p = 0.0322). On the ABC, significant improvements were observed in the treatment group in total score, irritability, stereotypy, hyperactivity, and speech (p < 0.03 for each), but not in the control group. In the treatment group compared to the control group, mean changes on the ABC total score and subscales were similar except a greater number of children improved in irritability (p = 0.0311). On the ATEC, sensory/cognitive awareness significantly improved (p = 0.0367) in the treatment group compared to the control group. Post-hoc analysis indicated that children over age 5 and children with lower initial autism severity had the most robust improvements. Hyperbaric treatment was safe and well-tolerated. CONCLUSION: Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air. TRIAL REGISTRATION: clinicaltrials.gov NCT00335790. Article Published Date : Mar 13, 2009

Abstract Title: Role of hyperbaric oxygen therapy in the treatment of bacterial spinal osteomyelitis. Abstract Source: J Neurosurg Spine. 2009 Jan;10(1):16-20. PMID: 19119927 Abstract Author(s): Raheel Ahmed, Meryl A Severson, Vincent C Traynelis Abstract: OBJECT: Hyperbaric oxygen therapy (HBO) is used as primary and/or adjunctive therapy in the treatment of various clinical conditions complicated by local hypoxia. It may have therapeutic potential in the treatment of neurosurgical infections such as spinal osteomyelitis that are associated with significant morbidity rates. The purpose of this study was to evaluate the efficacy of HBO therapy in the treatment of spinal osteomyelitis. METHODS: The clinical records of patients diagnosed with spinal osteomyelitis who received HBO therapy during their treatment at the authors' institution over the past 10 years were retrospectively reviewed. Six adult patients were identified. Four patients had recently undergone spinal surgery and secondary spinal osteomyelitis had developed. These patients received adjunctive HBO therapy due to significant comorbidities and risk factors for poor healing. RESULTS: All patients remained symptom and infection free over the subsequent follow-up period. Two patients had primary spinal osteomyelitis that had recurred despite a full course of appropriate antimicrobial therapy. Infection control was achieved after HBO therapy in 1 patient. The mean follow-up period for the study group was 2.9 years (range 5 months to 5 years). CONCLUSIONS: Hyperbaric oxygen therapy enabled infection cure in 5 of 6 patients with spinal osteomyelitis complicated by medical comorbidities or the failure of primary therapy. These results show that HBO may be a useful adjunctive therapeutic modality in the treatment of spinal osteomyelitis, particularly when there are medical comorbidities that increase the risk of poor healing. Hyperbaric oxygen therapy may also be beneficial in patients with relapsing primary spinal osteomyelitis after standard therapy has failed. Article Published Date : Jan 01, 2009

Abstract Title: A novel treatment modality for myofascial pain syndrome: hyperbaric oxygen therapy. Abstract Source: J Natl Med Assoc. 2009 Jan;101(1):77-80. PMID: 19245076 Abstract Author(s): Mehmet Zeki Kiralp, Günalp Uzun, Omit Dinçer, Ahmet Sen, Senol Yildiz, Levent Tekin, Hasan Dursun Article Affiliation: Department of Physical Medicine, Gülhane Military Medical Academy Haydarpaşa Training Hospital, Istanbul, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The aim of the present study was to evaluate the effects of hyperbaric oxygen (HBO) therapy on myofascial pain syndrome (MPS). Thirty patients with the diagnosis of MPS were divided into HBO (n=20) and control groups (n=10). Patients in the HBO group received a total of 10 HBO treatments in 2 weeks. Patients in the control group received placebo treatment in a hyperbaric chamber. Pain threshold and visual analogue scale (VAS) measurements were performed immediately before and after HBO therapy and 3 months thereafter. Additionally, Pain Disability Index (PDI) and Short Form 12 Health Survey (SF-12) evaluations were done before HBO and after 3 months. HBO therapy was well tolerated with no complications. In the HBO group, pain threshold significantly increased and VAS scores significantly decreased immediately after and 3 months after HBO therapy. PDI, Mental and Physical Health SF-12 scores improved significantly with HBO therapy after 3 months compared with pretreatment values. In the control group, pain thresholds, VAS score, and Mental Health SF-12 scores did not change with placebo treatment; however, significant improvement was observed in the Physical Health SF-12 test. We concluded that HBO therapy may be a valuable alternative to other methods in the management of MPS. Our results warrant further randomized, double-blinded and placebo-controlled studies to evaluate the possible role of HBO in the management of MPS. Article Published Date : Jan 01, 2009

Abstract Title: Low pressure hyperbaric oxygen therapy and SPECT brain imaging in the treatment of blast-induced chronic traumatic brain injury (post-concussion syndrome) and post traumatic stress disorder: a case report. Abstract Source: Cases J. 2009;2:6538. Epub 2009 Jun 9. PMID: 19829822 Abstract Author(s): Paul G Harch, Edward F Fogarty, Paul K Staab, Keith Van Meter Abstract: A 25-year-old male military veteran presented with diagnoses of post concussion syndrome and post traumatic stress disorder three years after loss of consciousness from an explosion in combat. The patient underwent single photon emission computed tomography brain blood flow imaging before and after a block of thirty-nine 1.5 atmospheres absolute hyperbaric oxygen treatments. The patient experienced a permanent marked improvement in his post-concussive symptoms, physical exam findings, and brain blood flow. In addition, he experienced a complete resolution of post-traumatic stress disorder symptoms. After treatment he became and has remained employed for eight consecutive months. This case suggests a novel treatment for the combined diagnoses of blast-induced post-concussion syndrome and post-traumatic stress disorder.

Abstract Title: [Quantitative study of therapeutic efficacy on early intervention of hyperbaric oxygen to model of steroid-induced avascular osteonecrosis of femoral head by multi-slice perfusion imaging]. Abstract Source: Zhonghua Yi Xue Za Zhi. 2008 Dec 9;88(45):3210-6. PMID: 19171096 Abstract Author(s): Jin-cai Yang, Zhen-yu Pan, Hua Gu, Nan Li, Xiao-jun Qian, Ren-you Zhai, Lian-hua Wu, Chun-jin Gao Abstract: OBJECTIVE: To quantitatively evaluate the hemodynamic status in animal models of steroid-induced avascular osteonecrosis of femoral head (SANFH) by multislice CT (MSCT) perfusion imaging, and estimate the therapeutic efficacy on early intervention of hyperbaric oxygen (HBO) to improve the region blood flow (rBF) of ischemic femoral head. METHODS: Forty-eight New Zealand male rabbits were injected with Escherichia coli endotoxin and methyl-prednisolone to establish SANFH models and then divided into 3 subgroups to undergo MSCT to measure the rBF, regional blood volume (rBV), and mean transit time (MTT) to obtain perfusion maps at the femoral head epiphysis, metaphysic, and neck of femur, and then were killed to undergo histological examination of the bilateral femoral heads 2, 4, and 6 weeks later respectively (Groups M(2), M(4), and M(6)). Twenty-four rabbits underwent HOB treatment after the second injection of E. c. endotoxin for 1-3 courses respectively (Groups H(1), H(2), and H(3)), and then underwent MSCT and pathological examination as described above. Eight rabbits were used as controls (Group N). RESULTS: (1) The rBF values of Groups M(2), M(4), and M(6) were all significantly lower than that of Group N (P < 0.001, < 0.001, and < 0.002). The rBF value of femoral head epiphysis of Group M(2) was remarkably lower than that of Group N, decreased to the lowest in Group M(4), and re-increased in Group M(6). The rBV value demonstrated similar change pattern in femoral head epiphysis. The MTT values of Groups M(2) and M(4) were longer than that of Group N, and then re-decreased in Group M(6). (2) It did differ significantly between the perfusion data of different femoral head anatomic regions in Groups M(2), M(4), M(6) and N (rBF: F = 52.190, P < 0.001; rBV: F = 42.677, P < 0.001; MTT: F = 3.09, P = 0.048). The changes of the perfusion data in femoral head epiphysis were more significant than those in other anatomic regions. (3) There were no statistically significant differences in the rBF value of the femoral head epiphysis and metaphysis (F = 2.081, P = 0.115; F = 1.142, P = 0.341), in the rBV value of the femoral metaphysis and neck of femur (F = 2.642, P = 0.059; F = 1.568, P = 0.209), and the MTT value of all the anatomic regions (F = 1.111, P = 0.347) among Groups H(1), H(2), H(3), and N. The rBF values of Groups H(1), H(2), and H(3) were statistically higher than those of the corresponding phase model groups (all P < 0.05). CONCLUSIONS: Able to detect hemodynamic status of femoral head, MSCT perfusion imaging technique may be used in the early detection of SANFH. Early intervention of HBO therapy can improve the blood perfusion of femoral head. Article Published Date : Dec 09, 2008

Abstract Title: Hyperbaric oxygen therapy in Thai autistic children. Abstract Source: J Med Assoc Thai. 2008 Aug;91(8):1232-8. PMID: 18788696 Abstract Author(s): Jessada Chungpaibulpatana, Tappana Sumpatanarax, Noppol Thadakul, Chansin Chantharatreerat, Maytinee Konkaew, Methira Aroonlimsawas Abstract: BACKGROUND: Autism is a developmental and behavioral pattern, the triad of impairments, 1. social interaction, 2. social communication, 3. imagination. Their memories are seemingly in picture or photo records. Difficulties in the treatment, management, and handling of autistic children are the main problems. Hyperbaric oxygen therapy (HBOT) is a modern treatment in Thailand for nitrogen imbalance (Decompression sickness syndrome or Caisson disease). HBOT can increase plasma oxygen to the tissues including the brain. OBJECTIVE: To determine whether Hyperbaric Oxygen Therapy is safe to use in children with autism, and has a statistically significant effect on autistic symptoms. This is the first study in Thailand. MATERIAL AND METHOD: Thai Autistic children (n = 7) received HBOT (1.3 atm., 10 sessions) treatment. Assessment was done before and after treatment in five domains: Social development, Fine motor and Eye-hand coordination, Language development, Gross motor development, Self-help skills. RESULTS: Improvement was shown in five domains with a significant level. Seventy-five percent of children shown improvement while 25% did not seem to respond to the treatment. CONCLUSION: HBOT is a new treatment for Thai autistic children. Many scientific studies recently have shown that HBOT could be an effective treatment for autistic children. It could improve the major autistic symptoms. Article Published Date : Aug 01, 2008

Abstract Title: Hyperbaric oxygen therapy as a prophylactic and treatment against ileus and recurrent intestinal obstruction soon after surgery to relieve adhesive intestinal obstruction. Abstract Source: J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e379-83. Epub 2007 Jun 25. PMID: 17593223 Abstract Author(s): Satoshi Ambiru, Nobuaki Furuyama, Fumio Kimura, Hiroaki Shimizu, Hiroyuki Yoshidome, Masaru Miyazaki, Hideaki Shimada, Takenori Ochiai Abstract: BACKGROUND AND AIM: Nonoperative management of cases of adhesive intestinal obstruction would be ideal, especially for patients who have recently undergone surgery to relieve the same condition. We aimed to examine whether hyperbaric oxygen (HBO) therapy might have therapeutic potential for the treatment of postoperative paralytic ileus and recurrent adhesive intestinal obstruction soon after surgery, to relieve adhesive intestinal obstruction, because of its unique mechanisms in these contexts. METHODS: A total of 133 patients were enrolled in the present study. We examined non-per os periods, hospital stay, and clinical course according to the postoperative course of the 133 patients. RESULTS: After surgical intervention, 75 patients left the hospital without morbidity. Nineteen patients were successfully administered prophylactic HBO therapy to facilitate intestinal motility and to prevent paralytic ileus. The remaining 39 patients suffered from postoperative paralytic ileus or early recurrence of obstruction during the same hospitalization period. The patients who underwent prophylactic HBO therapy had significantly shorter non-per os periods and hospital stays after surgery than those who were not initially given HBO therapy (P < 0.05). Similarly, there were significant differences in duration of hospital stay after surgery between patients with HBO therapy as treatment and those who received other conservative therapies (P < 0.05). CONCLUSIONS: HBO therapy may have a prophylactic effect on postoperative paralytic ileus and may be of therapeutic benefit in the management of early recurrent adhesive intestinal obstruction following surgery to relieve adhesive intestinal obstruction. Article Published Date : Aug 01, 2008

Abstract Title: Hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss (ISSNHL) in association with combined treatment. Abstract Source: Cuad Bioet. 2008 May-Aug;19(66):321-53. PMID: 21510273 Abstract Author(s): R Holy, M Navara, P Dosel, P Fundova, P Prazenica, A Hahn Article Affiliation: ENT Clinic, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The main basic effect of hyperbaric oxygenation (HBO2) on the human body, in our study, was an increased partial pressure of oxygen resulting from an increased amount of oxygen dissolved in plasma. Thus the plasma can become capable of carrying enough oxygen to meet the needs of the body's tissues. From 1 January 2004 to 31 December 2007, a total of 61 patients (62 ears) received medical treatment at the ENT clinic of the 3rd Faculty of Medicine, Charles University, and at the Central Military Hospital in Prague. Treatment consisted of a combination of vasodilatation infusion treatment and HBO2 therapy. The results were evaluated in a retrospective study. The overall percentage of patients showing improvement was 59.7%. However, for those patients who started HBO2 treatment within 10 days of onset, complete recovery, or significant improvement was noted in 65.9%. In contrast, patients who started treatment after 10 days of onset, improvement was noted in only 38.9%. NMR examination revealed that two patients had vestibular schwannoma (also known as acoustic neuroma). Article Published Date : May 01, 2008

Abstract Title: [Hyper- or normobaric oxygen therapy to treat migraine and cluster headache pain. Cochrane review]. Abstract Source: Schmerz. 2008 Apr;22(2):129-32, 134-6. PMID: 17885769 Abstract Author(s): A Schnabel, M Bennet, F Schuster, N Roewer, P Kranke Article Affiliation: Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Münster, Münster, Germany. Abstract: BACKGROUND: The aim of this systematic review was to assess the benefits and harms of supplemental oxygen (HBOT/NBOT) for treating and preventing migraine and cluster headaches. MATERIAL AND METHODS: All randomized trials comparing the effect of supplemental oxygen on migraine or cluster headache with those that exclude supplemental oxygen were included in this review. The systematic search included all relevant sources according to the paradigms of the Cochrane Collaboration. Data were analyzed with RevMan 4.2. RESULTS: Nine trials involving 201 participants satisfied the inclusion criteria. HBOT was effective in relieving an acute migraine and seemed to be sufficient in the treatment of an acute cluster attack. NBOT was effective in terminating acute cluster headache compared to sham treatment, but not in comparison to sublingual ergotamine. There was no evidence for any prophylactic effects. Serious adverse effects were not noted in the trials investigated. CONCLUSIONS: There is some evidence that HBOT is effective for termination of acute migraine. NBOT was similarly effective in cluster headache, however with sparse data. Because of costs and poor availability HBOT cannot be regarded as a routine therapy. Further indications in the case of treatment failure using standard therapy need to be defined based on data of future clinical trials. Article Published Date : Apr 01, 2008

Abstract Title: Hyperbaric oxygen induces endogenous neural stem cells to proliferate and differentiate in hypoxic-ischemic brain damage in neonatal rats. Abstract Source: Undersea Hyperb Med. 2008 Mar-Apr;35(2):113-29. PMID: 18500076 Abstract Author(s): Y J Yang, X L Wang, X H Yu, X Wang, M Xie, C T Liu Abstract: BACKGROUND AND PURPOSE: Studies suggest that after brain injury, hyperbaric oxygen (HBO2) is neuroprotective by stimulating cell proliferation. We examine whether HBO2 promotes neural stem cells (NSC) to proliferate and differentiate in neonatal hypoxic-ischemic (HI) rats. METHODS: Seven-day-old rat pups were subjected to unilateral carotid artery ligation followed by 2 hours of hypoxia (8% O2). HBO2 was administered (2 ATA (atmospheres absolutes), once daily for 7 days) within 3 hours after HI. The proliferating neural stem cells in the subventricular zone (SVZ) and dentate gyrus (DG) were dynamically examined by 5-bromo-2-deoxyuridine (BrdU)/nestin immunofluorescence. Nestin protein was detected by western blot analysis at various time points (from 6 hours to 14 days) after HI. The migrating NSC were examined by BrdU/doublecortin (DCX) immunofluorescence 7 and 14 days after HI. The phenotype of the newborn cells was identified by BrdU/beta-tubulin, BrdU/ glial fibrillary acidic protein (GFAP) and BrdU/O4 (oligodendrocyte marker) immunofluorescence. Myelin basic protein (MBP) was examined by immunohistochemistry and pathological changes of the brain tissue were detected 28 days after HI. RESULTS: In neonatal HI rats treated with HBO2, the proliferation of endogenous NSC was observed in the SVZ and DG. Cell numbers peaked 7 days after HI and proliferating NSC migrated to the cerebral cortex at 14 d after HI. Twenty-eight days after HI, an increase in newly generated neurons, oligodendrocytes and MBP was observed in the HBO2 group compared to the untreated and HI-treated rats. CONCLUSIONS: This study suggests that HBO2 treatment may promote neurogenesis of the endogenous NSC in neonatal HI rats, contributing to repair of the injured brain. Article Published Date : Mar 01, 2008

Abstract Title: Hyperbaric oxygen therapy for the treatment of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery: experience with 626 patients. Abstract Source: Hepatogastroenterology. 2007 Oct-Nov;54(79):1925-9 PMID: 18251130 Abstract Author(s): Satoshi Ambiru, Nobuaki Furuyama, Mitsuo Aono, Fumio Kimura, Hiroaki Shimizu, Hiroyuki Yoshidome, Masaru Miyazaki, Hideaki Shimada, Takenori Ochiai Abstract: BACKGROUND/AIMS: The results of hyperbaric oxygen (HBO) therapy for treatment of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery are unknown. METHODOLOGY: A retrospective review of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery in 626 patients required 758 admissions who underwent HBO therapy was undertaken to examine the efficacy of HBO therapy. RESULTS: The overall resolution rates for patients receiving HBO therapy in cases of postoperative paralytic ileus and adhesive intestinal obstruction were 92% and 85%, respectively. Among patients who were more than 75 years old, the therapies resolved 35 (97%) of 36 cases of postoperative paralytic ileus and 42 (81%) of 52 cases of adhesive intestinal obstruction, which was comparable to the results for patients less than 75 years old. The mortality rate was 1.2% overall. Complications related to HBO therapy occurred in 3.8% of the admissions, and most of them were not serious. CONCLUSIONS: These results suggest that HBO therapy might deserve further assessment for use in management of postoperative paralytic ileus and adhesive intestinal obstruction as a new modality. HBO therapy is safe and non-invasive, and may be useful in the elderly patients, since mortality was relatively low in this series. Article Published Date : Oct 01, 2007

Abstract Title: Factors influencing the outcome of lower-extremity diabetic ulcers treated with hyperbaric oxygen therapy. Abstract Source: Wound Repair Regen. 2007 May-Jun;15(3):322-31. PMID: 17537119 Abstract Author(s): Caroline E Fife, Cem Buyukcakir, Gordon Otto, Paul Sheffield, Tommy Love, Robert Warriner Article Affiliation: Department of Anesthesiology, The University of Texas Medical School at Houston, Texas, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: The objectives of this study were to report outcomes of a large number of patients receiving hyperbaric oxygen therapy (HBO(2)T) for diabetic lower-extremity ulcers, and to identify likely outcome predictors. Five hyperbaric facilities supplied data on 1,006 patients. A sixth clinic served as a validation sample for the regression-based prediction model, and later additional data from Memorial Hermann Hospital were added. The severity of lower-extremity lesions was assessed upon initiation of HBO(2)T using the Modified Wagner scale, and the outcome described as healed, partially healed, not improved, amputated, or died. Overall, 73.8% of patients improved (granulated or healed). Factors significantly related to outcome included renal failure, pack-year smoking history, transcutaneous oximetry, number of HBO(2)T treatments, and interruption of treatment regimen. Number of treatments per week and treatment pressure (2.0 vs. 2.4 atmospheres absolute) were not significant factors in outcome. Concomitant administration of autologous growth factor gel did not improve outcome. A multiple regression model was fitted to the data that can be used to predict the outcome of diabetic patients undergoing HBO(2)T. Given the high cost of amputation and rehabilitation, these data suggest that hyperbaric oxygen treatment should be an important adjunctive therapy to heal lower-extremity lesions, especially those with a Wagner grade of 3 or higher. Article Published Date : May 01, 2007

Abstract Title: Hyperbaric oxygen for adjuvant therapy for chronically recurrent mandibular osteomyelitis in childhood and adolescence. Abstract Source: J Oral Maxillofac Surg. 2007 Feb;65(2):186-91. PMID: 17236919 Abstract Author(s): Stefan Lentrodt, Jürgen Lentrodt, Norbert Kübler, Ulrich Mödder Abstract: PURPOSE: In this article, the question of whether adjuvant hyperbaric oxygen therapy (HBO) has a positive effect when treating chronically recurrent mandibular osteomyelitis in children and adolescents is discussed. PATIENTS AND METHODS: Over a period of 5 years, 4 cases were observed, 3 of which were submitted to adjuvant HBO. Details on the modalities of this type of treatment and the simultaneous intravenous administration of high doses of antibiotics are reported. RESULTS: All 3 patients have been free of any symptoms from 20 to 74 months (mean, 41 months) and therefore may most likely be regarded as healed. CONCLUSION: The small number of cases does not allow a final statement on the extent to which HBO contributed to the positive outcome. However, in our opinion, HBO is a most promising therapeutic option. Finally, the problems involved in prospective randomized studies of this rare disease are discussed in detail. Article Published Date : Feb 01, 2007

Abstract Title: Hyperbaric oxygen therapy for nonhealing vasculitic ulcers. Abstract Source: Clin Exp Dermatol. 2007 Jan;32(1):12-7. Epub 2006 Jul 27. PMID: 16879451 Abstract Author(s): S Efrati, J Bergan, G Fishlev, M Tishler, A Golik, N Gall Article Affiliation: The Institute of Hyperbaric Medicine and Wound Care Clinic, Assaf Harofeh Medical Center, Zerifin, Israel. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Cutaneous nonhealing ulceration is a threatening manifestation of vasculitis. Hyperbaric oxygen (HBO), frequently used as adjuvant therapy for patients with ischaemic ulcers, exerts additional beneficial effects on the vascular inflammatory response. AIM: To evaluate the effect of HBO on vasculitis-induced nonhealing skin ulcers. METHODS: The study population comprised 35 patients aged>or= 18 years with severe, nonhealing, vasculitis-induced ulcers that had not improved following immunosuppressive therapy. Baseline ulcer tissue oxygenation was evaluated at room air concentration (21% O2), at 1 atmosphere absolute (ATA) breathing 100% O2, and at 2 ATA breathing 100% O2. The baseline treatment protocol consisted of a 4-week course of 100% O2 for 90 min at 2 ATA, five times/week. RESULTS: The mean baseline ulcer tissue oxygenation (3.1 +/- 2.4 kPa at room air concentration), was significantly increased to 13.9 +/- 11.9 kPa at 1 ATA breathing 100% O2 (P<0.001), and subsequently increased further to 59.1 +/- 29.8 kPa at 2 ATA breathing 100% O2 (P<0.001). At the end of the hyperbaric therapy, 28 patients (80%) demonstrated complete healing, 4 (11.4%) had partial healing and 3 (8.6%) had no improvement. None of the patients had any side-effects related to the HBO therapy. CONCLUSION: HBO therapy may serve as an effective safe treatment for patients with vasculitis having nonhealing skin ulcers. Further studies are needed to evaluate its role as primary therapy for this group of patients. Article Published Date : Jan 01, 2007

Abstract Title: The effects of hyperbaric oxygen therapy on oxidative stress, inflammation, and symptoms in children with autism: an open-label pilot study. Abstract Source: BMC Pediatr. 2007;7:36. Epub 2007 Nov 16. PMID: 18005455 Abstract Author(s): Daniel A Rossignol, Lanier W Rossignol, S Jill James, Stepan Melnyk, Elizabeth Mumper Abstract: BACKGROUND: Recently, hyperbaric oxygen therapy (HBOT) has increased in popularity as a treatment for autism. Numerous studies document oxidative stress and inflammation in individuals with autism; both of these conditions have demonstrated improvement with HBOT, along with enhancement of neurological function and cognitive performance. In this study, children with autism were treated with HBOT at atmospheric pressures and oxygen concentrations in current use for this condition. Changes in markers of oxidative stress and inflammation were measured. The children were evaluated to determine clinical effects and safety. METHODS: Eighteen children with autism, ages 3-16 years, underwent 40 hyperbaric sessions of 45 minutes duration each at either 1.5 atmospheres (atm) and 100% oxygen, or at 1.3 atm and 24% oxygen. Measurements of C-reactive protein (CRP) and markers of oxidative stress, including plasma oxidized glutathione (GSSG), were assessed by fasting blood draws collected before and after the 40 treatments. Changes in clinical symptoms, as rated by parents, were also assessed. The children were closely monitored for potential adverse effects. RESULTS: At the endpoint of 40 hyperbaric sessions, neither group demonstrated statistically significant changes in mean plasma GSSG levels, indicating intracellular oxidative stress appears unaffected by either regimen. A trend towards improvement in mean CRP was present in both groups; the largest improvements were observed in children with initially higher elevations in CRP. When all 18 children were pooled, a significant improvement in CRP was found (p = 0.021). Pre- and post-parental observations indicated statistically significant improvements in both groups, including motivation, speech, and cognitive awareness (p<0.05). No major adverse events were observed. CONCLUSION: In this prospective pilot study of children with autism, HBOT at a maximum pressure of 1.5 atm with up to 100% oxygen was safe and well tolerated. HBOT did not appreciably worsen oxidative stress and significantly decreased inflammation as measured by CRP levels. Parental observations support anecdotal accounts of improvement in several domains of autism. However, since this was an open-label study, definitive statements regarding the efficacy of HBOT for the treatment of individuals with autism must await results from double-blind, controlled trials. TRIAL REGISTRATION: clinicaltrials.gov NCT00324909. Article Published Date : Jan 01, 2007

Abstract Title: Hyperbaric oxygen therapy might improve certain pathophysiological findings in autism. Abstract Source: J Neural Transm Suppl. 2007;(72):189-93. PMID: 17141962 Abstract Author(s): Daniel A Rossignol Abstract: Autism is a neurodevelopmental disorder currently affecting as many as 1 out of 166 children in the United States. Numerous studies of autistic individuals have revealed evidence of cerebral hypoperfusion, neuroinflammation and gastrointestinal inflammation, immune dysregulation, oxidative stress, relative mitochondrial dysfunction, neurotransmitter abnormalities, impaired detoxification of toxins, dysbiosis, and impaired production of porphyrins. Many of these findings have been correlated with core autistic symptoms. For example, cerebral hypoperfusion in autistic children has been correlated with repetitive, self-stimulatory and stereotypical behaviors, and impairments in communication, sensory perception, and social interaction. Hyperbaric oxygen therapy (HBOT) might be able to improve each of these problems in autistic individuals. Specifically, HBOT has been used with clinical success in several cerebral hypoperfusion conditions and can compensate for decreased blood flow by increasing the oxygen content of plasma and body tissues. HBOT has been reported to possess strong anti-inflammatory properties and has been shown to improve immune function. There is evidence that oxidative stress can be reduced with HBOT through the upregulation of antioxidant enzymes. HBOT can also increase the function and production of mitochondria and improve neurotransmitter abnormalities. In addition, HBOT upregulates enzymes that can help with detoxification problems specifically found in autistic children. Dysbiosis is common in autistic children and HBOT can improve this. Impaired production of porphyrins in autistic children might affect the production of heme, and HBOT might help overcome the effects of this problem. Finally, HBOT has been shown to mobilize stem cells from the bone marrow to the systemic circulation. Recent studies in humans have shown that stem cells can enter the brain and form new neurons, astrocytes, and microglia. It is expected that amelioration of these underlying pathophysiological problems through the use of HBOT will lead to improvements in autistic symptoms. Several studies on the use of HBOT in autistic children are currently underway and early results are promising. Article Published Date : Jan 01, 2007

Abstract Title: Hyperbaric oxygen therapy in cluster headache. Abstract Source: Cancer Lett. 2006 Nov 28;244(1):61-70. Epub 2006 Jan 18. PMID: 8455970 Abstract Author(s): F Di Sabato, B M Fusco, P Pelaia, M Giacovazzo Article Affiliation: Institute of Internal Medicine VI, University La Sapienza, Rome, Italy. Abstract: Preliminary reports have shown that hyperbaric oxygen (HBO) interrupts cluster headache (CH) attacks. In the present study, 6 of 7 patients with episodic cluster headache who were treated with hyperbaric oxygen experienced an interruption of the attack. In 3 of 6 responders the florid period of the cluster headache was interrupted. The other 3 patients remained without pain attacks for a period lasting from 3 to 6 days. In 6 different patients, a placebo treatment had no effect. The present findings clearly indicate that hyperbaric oxygen has not only a symptomatic effect on a single attack of cluster headache, but it also could prevent the occurrence of subsequent attacks. Article Published Date : Nov 28, 2006

Abstract Title: Hyperbaric oxygen treatment decreases inflammation and mechanical hypersensitivity in an animal model of inflammatory pain. Abstract Source: Brain Res. 2006 Jul 7 ;1098(1):126-8. Epub 2006 Jun 5. PMID: 16750177 Abstract Author(s): Hilary D Wilson, Judy R Wilson, Perry N Fuchs Article Affiliation: Hilary D Wilson Abstract: Hyperbaric oxygen therapy has been used to treat a variety of ailments from carbon monoxide poisoning to fibromyalgia. The purpose of this experiment was to explore the effect of hyperbaric oxygen treatment on carrageenan-induced inflammation and pain in rats. Hyperbaric oxygen treatment significantly decreased inflammation and pain following carrageenan injection. Clinically hyperbaric oxygen may be used in situations where NSAIDS are contraindicated or in persistent cases of inflammation. Article Published Date : Jul 06, 2006

Abstract Title: Hyperbaric oxygen therapy in the management of two cases of hydrogen sulfide toxicity from liquid manure. Abstract Source: CJEM. 2005 Jul;7(4):257-61. PMID: 17355683 Abstract Author(s): Richard Belley, Nicolas Bernard, Mario Côté, Francois Paquet, Julien Poitras Article Affiliation: Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l'Université Laval, Université Laval, Québec, Québec, Canada. Abstract: Hydrogen sulfide is a potent lethal gas. Supportive care, nitrite therapy and hyperbaric oxygen are the treatment modalities reported in the literature in cases of hydrogen sulfide exposure. We describe an industrial exposure in which 6 workers inhaled high concentrations of hydrogen sulfide when they entered a closed spreader tank partially filled with liquid swine manure. Five of the 6 lost consciousness, and 2 were agitated and poorly responsive on arrival to the emergency department despite having already received high-flow oxygen for nearly 1 hour. These 2 patients received nitrite therapy followed by orotracheal intubation and hyperbaric oxygen. All patients were discharged home without sequelae after short stays in hospital. The emergency management of hydrogen sulfide exposure is briefly reviewed. Article Published Date : Jul 01, 2005

Abstract Title: Hyperbaric oxygen for the treatment of interstitial cystitis: long-term results of a prospective pilot study. Abstract Source: Eur Urol. 2004 Jul;46(1):108-13. PMID: 15183555 Abstract Author(s): Arndt van Ophoven, Gordon Rossbach, Frank Oberpenning, Lothar Hertle Abstract: OBJECTIVE: We conducted a prospective pilot study to assess the safety and efficacy of hyperbaric oxygen (HBO) for the treatment of interstitial cystitis (IC). METHODS: Six patients underwent 30 sessions of 100% oxygen inhalation in a hyperbaric chamber and were followed up over 15 months. The measures of efficacy were changes in pain and urgency (visual analog scales), alteration in the patient's assessment of overall change in his well-being (Patient Global Assessment Form), and changes in frequency and functional bladder capacity (48-hours voiding log). Evaluation of symptom severity regarding pain and voiding problems was done using the O'Leary-Sant index. RESULTS: Four patients rated the therapeutic result as either excellent or good and assessed their well-being after HBO treatment as improved. Two patients showed only short-term amelioration of some of their symptoms. At 12 months follow-up the baseline functional bladder capacity increased from 37-161 ml (range) to 160-200 ml in the responder group. The 24-hour voiding frequency decreased from 15-27 to 6-11 voids per day, a pain scale improvement from 20-97 mm at baseline to 3-30 mm at 12 months follow-up and an urgency scale improvement from 53-92 mm to 3-40 mm, respectively was observed at 12 month follow-up. The symptom and pain index score decreased from 23-35 at baseline to 3-17 at 12 months follow-up. CONCLUSION: HBO appears to be effective to treat IC patients. Treatment was well tolerated and resulted in a sustained decrease of pelvic pain and urgency, improvement of voiding patterns and increase of functional bladder capacity for at least 12 months. Copyright 2004 Elsevier B.V. Article Published Date : Jul 01, 2004

Abstract Title: A new treatment modality for fibromyalgia syndrome: hyperbaric oxygen therapy. Abstract Source: J Int Med Res. 2004 May-Jun;32(3):263-7. PMID: 15174219 Abstract Author(s): S Yildiz, M Z Kiralp, A Akin, I Keskin, H Ay, H Dursun, M Cimsit Article Affiliation: GATA Haydarpaşa Military Hospital, Istanbul, Turkey. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Fibromyalgia syndrome (FMS) is characterized by longstanding multifocal pain with generalized allodynia/hyperalgesia. There are several treatment methods but none has been specifically approved for this application. We conducted a randomized controlled study to evaluate the effect of hyperbaric oxygen (HBO) therapy in FMS (HBO group: n = 26; control group: n = 24). Tender points and pain threshold were assessed before, and after the first and fifteenth sessions of therapy. Pain was also scored on a visual analogue scale (VAS). There was a significant reduction in tender points and VAS scores and a significant increase in pain threshold of the HBO group after the first and fifteenth therapy sessions. There was also a significant difference between the HBO and control groups for all parameters except the VAS scores after the first session. We conclude that HBO therapy has an important role in managing FMS. Article Published Date : May 01, 2004

Abstract Title: [Rhino-cerebral fungal infection successfully treated with supplementary hyperbaric oxygen therapy]. Abstract Source: Rev Neurol (Paris). 2003 Dec;159(12):1178-80. PMID: 14978421 Abstract Author(s): N Chassaing, L Valton, M Kany, E Bonnet, E Uro-Coste, M-B Delisle, P Bousquet, G Géraud Abstract: Rhino-cerebral fungal infections are rare and difficult disorders to cure. We report the case of a woman presenting a left trigeminal neuralgia complicated by ophthalmoplegia and blindness. MRI demonstrated a lesion of the left orbital apex with extension into the cavernous sinus. Fungal infiltration (aspergillosis or mucormycosis), was seen on biopsy. High-dose liposomal Amphotericin B (5mg/kg/day) for six weeks was unsuccessful. Adjunctant hyperbaric oxygen therapy led to clinical and radiological improvement. Hyperbaric oxygen therapy is discussed in the medical management of rhino-cerebral yeast abscesses. Article Published Date : Dec 01, 2003

Abstract Title: Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers: a prospective randomized study. Abstract Source: Diabetes Care. 2003 Aug;26(8):2378-82. PMID: 12882865 Abstract Author(s): Laurence Kessler, Pascal Bilbault, Francoise Ortéga, Claire Grasso, Raphael Passemard, Dominique Stephan, Michel Pinget, Francis Schneider Article Affiliation: Department of Endocrinology and Diabetology, University Hospital, Strasbourg, France. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: OBJECTIVE: To study the effect of systemic hyperbaric oxygenation (HBO) therapy on the healing course of nonischemic chronic diabetic foot ulcers. RESEARCH DESIGN AND METHODS: From 1999 to 2000, 28 patients (average age 60.2 +/- 9.7 years, diabetes duration 18.2 +/- 6.6 years), of whom 87% had type 2 diabetes, demonstrating chronic Wagner grades I-III foot ulcers without clinical symptoms of arteriopathy, were studied. They were randomized to undergo HBO because their ulcers did not improve over 3 months of full standard treatment. All the patients demonstrated signs of neuropathy. HBO was applied twice a day, 5 days a week for 2 weeks; each session lasted 90 min at 2.5 ATA (absolute temperature air). The main parameter studied was the size of the foot ulcer measured on tracing graphs with a computer. It was evaluated before HBO and at day 15 and 30 after the baseline. RESULTS: HBO was well tolerated in all but one patient (barotraumatic otitis). The transcutaneous oxygen pressure (TcPO(2)) measured on the dorsum of the feet of the patients was 45.6 +/- 18.1 mmHg (room air). During HBO, the TcPO(2) measured around the ulcer increased significantly from 21.9 +/- 12.1 to 454.2 +/- 128.1 mmHg (P<0.001). At day 15 (i.e., after completion of HBO), the size of ulcers decreased significantly in the HBO group (41.8 +/- 25.5 vs. 21.7 +/- 16.9% in the control group [P = 0.037]). Such a difference could no longer be observed at day 30 (48.1 +/- 30.3 vs. 41.7 +/- 27.3%). Four weeks later, complete healing was observed in two patients having undergone HBO and none in the control group. CONCLUSIONS: In addition to standard multidisciplinary management, HBO doubles the mean healing rate of nonischemic chronic foot ulcers in selected diabetic patients. The time dependence of the effect of HBO warrants further investigations. Article Published Date : Aug 01, 2003

Abstract Title: Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up. Abstract Source: J Diabetes Complications. 2002 Mar-Apr;16(2):153-8. PMID: 12039398 Abstract Author(s): Majid Kalani, Gun Jörneskog, Nazanin Naderi, Folke Lind, Kerstin Brismar Article Affiliation: Department of Emergency Medicine, Karolinska Hospital, Stockholm, Sweden. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: The cause of diabetic foot ulcers is multifactorial, e.g., neuropathy and angiopathy, leading to functional disturbances in the macrocirculation and skin microcirculation. Adequate tissue oxygen tension is an essential factor in infection control and wound healing. Hyperbaric oxygen (HBO) therapy, daily sessions of oxygen breathing at 2.5-bar increased pressure in a hyperbaric chamber, has beneficial actions on wound healing including antimicrobial action, prevention of edema and stimulation of fibroblasts. The aim of the present study was to investigate the long-term effect of HBO in treatment of diabetic foot ulcers. METHODS: Thirty-eight diabetic patients (30 males) with chronic foot ulcers were investigated in a prospective study. The mean age was 60+/-13 years and the mean diabetes duration 27+/-14 years. All patients were evaluated with measurements of transcutaneous oxygen tension (tcPO(2)), peripheral blood pressure, and HbA(1c). All patients had a basal tcPO(2) value lower than 40 mmHg, which increased to>/=100 mmHg, or at least three times the basic value, during inhalation of pure oxygen. Seventeen patients underwent 40-60 sessions of HBO therapy, while 21 patients were treated conventionally. The follow-up time was 3 years. RESULTS: 76% of the patients treated with HBO (Group A) had healed with intact skin at a follow-up time of 3 years. The corresponding value for patients treated conventionally (Group B) was 48%. Seven patients (33%) in Group B compared to two patients (12%) in Group A went to amputation. Peripheral blood pressure, HbA(1c), diabetes duration, and basal values of tcPO(2) were similar in both groups. CONCLUSIONS: Adjunctive HBO therapy can be valuable for treating selected cases of hypoxic diabetic foot ulcers. It seems to accelerate the rate of healing, reduce the need for amputation, and increase the number of wounds that are completely healed on long-term follow-up. Additional studies are needed to further define the role of HBO, as part of a multidisciplinary program, to preserve a functional extremity, and reduce the short- and long-term costs of amputation and disability. Article Published Date : Mar 01, 2002

Abstract Title: Hyperbaric oxygen in chronic cluster headaches: influence on serotonergic pathways. Abstract Source: Undersea Hyperb Med. 1997 Jun;24(2):117-22. PMID: 9171470 Abstract Author(s): F Di Sabato, M Rocco, P Martelletti, M Giacovazzo Article Affiliation: Department of Clinical Medicine, Headache Centre, University La Sapienza, Rome, Italy. Abstract: A controlled study was done with the aim of assessing the efficacy of hyperbaric oxygen (HBO2) in cluster headache and of studying the possible influence of this therapeutic approach on serotonergic pathways. Fourteen patients, aged between 26 and 56 yr, suffering from the chronic form of cluster headache were treated with HBO2 (n = 10) or environmental air (placebo) ( n = 4) during the 15 sessions of exposure (lasting 30 min each) in the hyperbaric chamber. The influence of this procedure on serotonergic pathways of pain was monitored by means of study of serotonin binding to mononuclear cells before and after the treatment for both subgroups. All of the treated 14 chronic cluster headache patients completed the study. In the subgroup treated with the placebo, no particular modifications on the number of attacks and of analgesic consumption as well as no change in the specific binding curve of serotonin to mononuclear cells were observed, whereas in the subgroup treated with HBO2 the clinical effectiveness and the appearance of plateau in the binding curves indicated that the oxygen therapy could act through serotonergic pathways. Article Published Date : Jun 01, 1997

Abstract Title: Hydrogen sulfide poisoning treated with hyperbaric oxygen. Abstract Source: J Emerg Med. 1985;3(1):23-5. PMID: 4093554 Abstract Author(s): D D Whitcraft, T D Bailey, G B Hart Abstract: Hydrogen sulfide inhalation injury can be life threatening. The toxic gas is produced, sometimes unexpectedly, from a wide variety of sources. Because its mechanism of toxicity is similar to that of cyanide, hydrogen sulfide poisoning is commonly treated with the nitrite component of the cyanide antidote kit. In this case report, hyperbaric oxygen was successfully used to treat hydrogen sulfide intoxication. Further evaluation of hyperbaric oxygen therapy as adjunctive treatment of hydrogen sulfide poisoning is recommended. Article Published Date : Jan 01, 1985