Search Results (81)

Pre-eclampsia (PE) is a hypertensive pregnancy complication. Oxidative stress is hypothesized to contribute to the pathophysiology of PE. Both the hydrogen sulfide (H₂S) and oxytocin (OT) systems might play a role in the pathophysiology of PE, like their antioxidant and hypotensive effects. Thus, the role of the interaction of the OT and H₂S systems in the context of PE was further elucidated in the present clinical case–control study “NU-HOPE” (Nürnberg-Ulm: The role of H₂S and Oxytocin Receptor in Pre-Eclampsia; ethical approval by the Landesärztekammer Bayern, file number 19033, 29 August 2019), comparing uncomplicated pregnancies, early onset PE (ePE, onset < 34 weeks gestational age) and late onset PE (lPE, onset > 34 weeks gestational age). Routine clinical data, serum H₂S and homocysteine levels, and tissue protein expression, as well as nitrotyrosine formation, were determined. The main findings were (i) unchanged plasma sulfide levels, (ii) significantly elevated homocysteine levels in ePE, but not lPE, (iii) significantly elevated expression of H₂S enzymes and OT receptor in the placenta in lPE, and (iv) significantly elevated nitrotyrosine formation in the lPE myometrium. Taken together, these findings suggest a role for the interaction of the endogenous H₂S- and OT/OTR systems in the pathophysiology of pre-eclampsia, possibly linked to impaired antioxidant protection. Full article

Necrotizing soft tissue infection (NSTI) is a life-threatening, high morbidity pathology that requires aggressive, multidisciplinary management. Surgery and antibiotic administration are core components of treatment. Adjunctive incorporation of hyperbaric oxygen therapy (HBOT) can further enhance treatment and recovery. Benefit is achieved through multiple effects brought about by increase of local and systemic oxygen tension. Direct effects include bacteriostasis, disruption of bacterial toxin production, and attenuation of inflammation. Indirect benefits include demarcation of viable tissue to enhance surgical efforts, potentiation of antibiotics, and enhancement of immune system function. Overall, HBOT has few contraindications and is typically well tolerated by patients. Treatment course and appropriateness of individual patients can be determined through consultation with Hyperbaric Medicine specialists. The benefits of HBOT in morbidity and mortality of NSTI have been well demonstrated and this therapy should be considered as a component of care to all affected patients. Full article

Background/Objectives: The concept of the “smoker’s paradox” in prior research posits that smoking could potentially offer neuroprotective effects in cases of acute carbon monoxide (CO) poisoning. This study aimed to determine the validity of this hypothesis by minimizing selection bias and confounding variables in a comparison of neurocognitive outcomes between smokers and non-smokers following acute CO poisoning. Methods: A total of 1150 patients were included in this retrospective study. Propensity Score Matching (PSM) was used to control for variables such as age, initial Glasgow Coma Scale (GCS) score, co-morbidities, and HBO₂ therapy application. Neurocognitive outcomes were assessed and compared between smokers and non-smokers. Results: In the initial analysis, 1150 patients were divided into non-smoking (61.7%) and smoking (38.3%) groups. Before PSM, smokers had a lower rate of poor outcomes (12.1% vs. 6.8%, p = 0.004). However, baseline differences emerged, with non-smokers being older with longer CO exposure, while smokers had more males and higher rates of intentional CO poisoning and drug ingestion. Smokers had a 0.56 times lower relative risk of poor outcomes compared to non-smokers (95% CI: 0.38–0.84, p = 0.004). After meticulous 1:1 PSM with 15 covariates, 317 patient pairs were matched, creating balanced cohorts. Neurocognitive outcomes at 1 month post-CO exposure showed no significant differences between matched non-smoking and smoking groups (9.8% vs. 7.9%, p = 0.461). Post-PSM, the relative risk for poor outcomes remained approximately 0.81 times lower in smokers compared to non-smokers, but with no statistical significance [0.81 (95% CI: 0.49–1.33, p = 0.402)]. Conclusions: Our findings do not support the idea of a protective effect from smoking in the context of acute CO poisoning. After accounting for potential confounders through PSM, we found that smoking status was not significantly associated with more favorable neurocognitive outcomes. Full article

Background and Objectives: Hyperbaric oxygen therapy (HBOT) has shown promise in managing complications due to cancer treatments, particularly those related to radiotherapy and surgery. Despite its clinical benefits, concerns persist regarding its potential to influence cancer progression. This study aimed to evaluate the safety and clinical outcomes of HBOT in patients with active or previously treated solid tumors. Methods: A retrospective analysis was conducted on patients with solid tumors who underwent at least five HBOT sessions. Comprehensive data, including patient demographics, cancer type, total number of HBOT sessions, imaging findings, and clinical outcomes (recurrence, metastasis, and mortality), were collected. Descriptive statistics and the relationship between the number of HBOT sessions and long-term cancer outcomes were analyzed. Results: This study included 45 patients (median age: 64 years; 60% male) who received a median of 27 HBOT sessions. At initiation, 27.9% of the patients were classified as cured, 53.5% were in remission, and 18.6% had active cancer. Over a median follow-up period of 783 days, 8.7% experienced recurrence, 2.7% had persistent active cancer, and 59.5% had no recurrence. No HBOT-related complications were observed during the course of HBOT. Statistical analyses revealed no significant correlations between the number of HBOT sessions and metastasis (p = 0.213) or mortality (p = 0.881). Conclusions: HBOT appears to be a safe and effective adjunctive therapy for managing complications in patients with solid tumors. No evidence was found to suggest HBOT contributes to tumor progression, recurrence, or metastasis. Future prospective studies with larger cohorts are needed to confirm these results and further evaluate the therapeutic role of HBOT in oncology. Full article

Since the initial identification of SARS-CoV-2 infections, numerous clinical challenges have arisen, revealing both acute and long-term effects associated with COVID-19. These effects impact various systems within the body, including the respiratory, cardiovascular, and nervous systems. Background/Objectives: This study aimed to investigate the immunological and inflammatory parameters in patients with severe COVID-19 and evaluate the effects of hyperbaric oxygen therapy (HBOT) on these parameters. Methods: This study enrolled thirty patients from the Military Medical Institute—National Research Institute in Warsaw, who were hospitalized for SARS-CoV-2 infection. Patients were screened for eligibility based on pre-defined inclusion criteria. The subjects were randomly assigned to one of two groups: hyperbaric oxygen therapy (HBOT) or a control group. Immune profiling was performed, measuring cytokine concentrations and leukocyte subpopulations in serum samples. Outcomes were assessed using Bayesian modeling. Results: Bayesian regression analysis confirmed previous findings, indicating that HBOT may reduce inflammatory cytokine levels while improving oxygen saturation (SpO₂) in patients with moderate and severe COVID-19. Moreover, the analysis suggested a higher probability of HBOT success in modulating the immune response and reducing inflammatory parameters, particularly in T lymphocyte subpopulations. Conclusions: Hyperbaric oxygen therapy (HBOT) may serve as an effective adjunctive treatment for patients with COVID-19 by enhancing oxygen saturation and modulating the immune response. Further studies are needed to elucidate the underlying mechanisms of HBOT on inflammatory and immunological parameters in COVID-19 patients. Full article

Background: We aimed to investigate the association between acute carbon monoxide (CO) poisoning and the risk of internal malignancies, including hematologic malignancies. Methods: The study population was derived from the National Health Insurance Service (NHIS) database of Korea between 2002 and 2022. Adults diagnosed with CO poisoning and controls were included. Demographics, socioeconomic statuses, lifestyle factors, and comorbidity profiles of participants were retrieved from the NHIS database. Covariates potentially associated with disease outcomes were selected based on the available literature and biological plausibility, balanced between the two cohorts using inverse probability of treatment weighting, and applied to adjust multivariable models. Results: Overall, 42,874 patients with CO poisoning and 905,285 controls were included; both cohorts comprised 44.3% females. The mean age of the CO poisoning and controls was 51.5 and 50.9 years, respectively. Patients with CO poisoning had a 1.02-fold increase in the overall risk of malignancy (a 1.03-fold increase in solid organ malignancies and a 0.71-fold decrease in hematologic malignancies) compared with controls. The risk of internal malignancy was increased in the oral cavity (adjusted hazard ratio, 1.33; 95% confidence intervals, 1.19–1.49), lungs (1.39; 1.33–1.46), bone (1.68; 1.23–2.30), cervix (1.32; 95% CI, 1.17–1.49), and kidneys (1.14; 1.04–1.24). Conversely, the risk of internal malignancies was decreased in the thorax (0.59; 0.45–0.77), anus (0.14; 0.06–0.34), uterus (0.71; 0.60–0.82), ovaries (0.59; 0.45–0.77), prostate (0.89; 0.84–0.95), Hodgkin lymphoma (0.35; 0.20–0.61), non-Hodgkin lymphoma (0.67; 0.59–0.75), and multiple myeloma (0.36; 0.30–0.43). Conclusions: CO poisoning was associated with the development of internal malignancies. Full article

Maintaining the physiological function of the vascular endothelium and endothelial glycocalyx is crucial for the prevention of cardiovascular disease, which is one of the leading causes of morbidity and mortality worldwide. Damage to these structures can lead to atherosclerosis, hypertension, and other cardiovascular problems, especially in individuals with risk factors such as diabetes and obesity. Endothelial dysfunction is associated with ischemic disease and has a negative impact on overall cardiovascular health. The aim of this review was to comprehensively summarize the crucial role of the vascular endothelium and glycocalyx in cardiovascular health and associated thrombo-inflammatory conditions. It highlights how endothelial dysfunction, influenced by factors such as diabetes, chronic kidney disease, and obesity, leads to adverse cardiovascular outcomes, including heart failure. Recent evidence suggests that hyperbaric oxygen therapy (HBOT) may offer therapeutic benefits in the treatment of cardiovascular risk factors and disease. This review presents the current evidence on the mechanisms by which HBOT promotes angiogenesis, shows antimicrobial and immunomodulatory effects, enhances antioxidant defenses, and stimulates stem cell activity. The latest findings on important topics will be presented, including the effects of HBOT on endothelial dysfunction, cardiac function, atherosclerosis, plaque stability, and endothelial integrity. In addition, the role of HBOT in alleviating cardiovascular risk factors such as hypertension, aging, obesity, and glucose metabolism regulation is discussed, along with its impact on inflammation in cardiovascular disease and its potential benefit in ischemia–reperfusion injury. While HBOT demonstrates significant therapeutic potential, the review also addresses potential risks associated with excessive oxidative stress and oxygen toxicity. By combining information on the molecular mechanisms of HBOT and its effects on the maintenance of vascular homeostasis, this review provides valuable insights into the development of innovative therapeutic strategies aimed at protecting and restoring endothelial function to prevent and treat cardiovascular diseases. Full article

Epidemiological studies have linked fine dust pollution to depression, yet the underlying mechanisms remain unclear. Oxidative stress and endoplasmic reticulum (ER) stress are known contributors to depression, but their induction by particulate matter (PM), particularly PM2.5, in animal models has been limited. This study aimed to establish a rat model of PM2.5-induced depression-like behaviors and elucidate the underlying molecular mechanisms. Adult male Sprague–Dawley rats received daily intranasal PM2.5 for four weeks. Behavioral assessments, including the open field test (OFT), forced swim test (FST), and light-dark box (LDB) test, were conducted weekly. PM2.5-exposed rats displayed depressive-like behaviors, particularly in the FST, reflecting decreased motivation and learned helplessness. Molecular analyses indicated a specific increase in ER stress markers (CHOP, eIF2α, GRP78, and P16) and NOX4 in the hypothalamus, while other brain regions (striatum, cortex, and hippocampus) were not as pronounced. Additionally, PM2.5 exposure reduced tyrosine hydroxylase (TH) levels in the hypothalamus, suggesting impaired dopamine synthesis. These findings indicate that PM2.5 induces depressive-like behaviors via hypothalamic ER stress and oxidative stress pathways, leading to dopaminergic dysfunction. Targeting oxidative and ER stress within the hypothalamus may offer new therapeutic strategies for treating depression associated with environmental pollutants. Full article

Background: Despite incidence rates and complications, the clinical management of xerostomia lacks guidelines. Aim: The aim of this overview is to summarize the clinical experience over the past 10 years of treating xerostomia using non-pharmacological interventions. Materials and Methods: A literature search was conducted across PubMed, EMBASE, Web of Science, ScienceDirect, and Google Scholar databases, covering publications from 1 January 2013 to 30 January 2023. Results: Topical therapies are the mainstays in cases of longstanding oral dryness. Their aim is to relieve oral discomfort by retaining mouth moisture. Macro-molecular lubricants were largely used in xerostomia due to radiotherapy for Head and Neck cancer (HNC) and xerostomia due to the chronic use of drugs. However, none of them provided stable relief for dry mouth. Traditional Medicine (TM), through the administration of different medicinal herbs and plants, has recently been evaluated against xerostomia in clinical trials. Matricaria chamomilla L., Linum usitatissimum, and Malva sylvestris L. together with Althea digitata Boiss, Licorice root, and Salvia Officinalis are among the most used compounds. They were formulated as water extracts with health benefits that are attributed to the presence of polyphenols. However, the low number of clinical evaluations represents the greatest limitation for validating the efficacy of TM against xerostomia. Regarding acupuncture, it did not show significant effects in the trials in comparison to the control groups. Further, electrostimulation, photo-biomodulation and hyperbaric therapy need more randomized clinical evaluations to effectively demonstrate their ability to relieve dry mouth. Conclusions: No topical treatment has shown stable relief of xerostomia. Consequently, the management of xerostomia and its devastating complications remain a significant void in daily clinical practice. Full article

Cryotherapy is widely used in veterinary medicine to manage pain and swelling, yet optimal methods for specific tissue depths remain unclear. Cryotherapy modalities, including cold packs (CPs), cold compression (CC), and hyperbaric gaseous cryotherapy (HGC), were applied to nine beagle dogs under general anaesthesia. A custom 3D-printed guide facilitated consistent and accurate measurements of tissue temperatures at depths of 1 and 3 cm. After a 20 min application, all modalities significantly reduced the muscular tissue temperatures at both measured depths. HGC exhibited the most effective rapid temperature reduction, whereas CC displayed the most extended sustained cooling effect. In comparison, CPs showed a lower temperature reduction. The effectiveness of cryotherapy varies with tissue depth, and selecting the appropriate method can improve therapeutic outcome. Full article

Background: Hyperbaric oxygen therapy (HBOT) involves inhaling nearly 100% oxygen in a pressurized environment and is commonly used to treat various diseases and injuries. Despite its well-known safety, HBOT is associated with side effects, with frequent middle ear barotrauma (MEB) and oxygen toxicity. Understanding the characteristics and risk factors associated with these side effects is critical for improving patient compliance and treatment outcomes. Methods: This retrospective multicenter study aimed to analyze the characteristics and factors associated with side effects during HBOT using a computer-controlled pressurized monoplace hyperbaric chamber. We conducted a retrospective observational study across the two tertiary hospitals in Korea, involving patients who received HBOT from October 2016 for one hospital and October 2017 for another hospital to June 2020. Data were extracted from electronic medical records and hyperbaric chamber logs, including patient demographics, medical history, HBOT indications, and details of side effects. Statistical analyses, including chi-square and t-tests, were used to compare variables. Results: A total of 247 patients (mean age: 59.35 ± 15.05 years, 63.56% male) were included. The most common indications for HBOT were sudden sensorineural hearing loss (27.94%) and post-graft/flap (24.29%). Hypertension (46.15%) and diabetes mellitus (39.27%) were the most frequent comorbidities. Otalgia was the most prevalent side effect (33.20%), followed by chest discomfort (2.02%) and headache (1.62%). A significant proportion of patients (11.74%) terminated HBOT due to side effects, with most pauses occurring at pressures between 1.2 and 1.4 ATA (26.67%). Side effects, particularly otalgia, significantly impact patient compliance with HBOT. Conclusions: The incidence of side effects varies by pressure level during treatment, suggesting the need for tailored strategies to minimize side effects. This study highlights the importance of patient monitoring and education to improve the safety and efficacy of HBOT in monoplace chambers. Full article

In veterinary medicine, hyperbaric oxygen chamber treatment (HBOT) is gaining popularity. Therefore, an increasing number of patients referred for this therapy are being recorded, mainly due to ischemic events, wound healing support, and a high risk of reperfusion damage. During the HBOT procedure, several changes occur in the body’s micro- and macroenvironments. This study involved 34 dogs of various ages and health statuses. The atmospheric conditions in the test hyperbaric chamber included a pressure of 1.5 atmosphere absolute (ATA) at 100% oxygenation. The individuals were divided into three groups: (1) individuals with degenerative mitral valve disease (DMVD), (2) individuals with diseases other than cardiac issues, and (3) healthy individuals who qualified for the HBOT procedure. The period of measurement using the Holter apparatus was divided into four stages: 30 min before the subject’s placement in the hyperbaric chamber; a 4-min compression period (setting chamber conditions); a 90 min HBOT period; and a 1 min decompression period of the hyperbaric chamber. During the HBOT, there was a statistically significant decrease in heart rate in groups 2 and 3 compared to group 1. The heart rate in group 1 remained unchanged through every period of the study. In addition, some of the dogs developed respiratory arrhythmia; in two dogs, premature ventricle beats occurred. The changes observed during the ventricular period indicate that the HBOT procedure causes a significant change in heart rate in dogs without cardiac diseases. Full article

Background: The application of normo- and hyperbaric O₂ is a common therapy option in various disease patterns. Thereby, the applied O₂ affects the whole body, including the blood and its components. This study investigates influences of pressure and oxygen fraction on human blood plasma, nutrient media, and the functions of neutrophil granulocytes (PMNs). Methods: Neutrophil migration, reactive oxygen species (ROS) production, and NETosis were examined by live cell imaging. The treatment of various matrices (Roswell Park Memorial Institute 1640 medium, Dulbecco’s Modified Eagle’s Medium, H₂O, human plasma, and isolated PMNs) with hyperbaric oxygen (HBO) was performed. In addition, the expression of different neutrophil surface epitopes (CD11b, CD62L, CD66b) and the oxidative burst were investigated by flow cytometry (FACS). The application of cold atmospheric plasma (CAP) to normoxic and normobaric culture media served as a positive control. Soluble reaction products such as H₂O₂, reactive nitrogen species (RNS: NO₂⁻ and NO₃⁻), and ROS-dependent dihydrorhodamine oxidation were quantified by fluoro- and colorimetric assay kits. Results: Under normobaric normoxia, PMNs migrate slower and shorter in comparison with normobaric hyper- or hypoxic conditions and hyperbaric hyperoxia. The pressure component has less effect on the migration behavior of PMNs than the O₂ concentration. Individual PMN cells produce prolonged ROS at normoxic conditions. PMNs showed increased expression of CD11b in normobaric normoxia, lower expression of CD62L in normobaric normoxia, and lower expression of CD66b after HBO and CAP treatment. Treatment with CAP increased the amount of ROS and RNS in common culture media. Conclusions: Hyperbaric and normobaric O₂ influences neutrophil functionality and surface epitopes in a measurable way, which may have an impact on disorders with neutrophil involvement. In the context of hyperbaric experiments, especially high amounts of H₂O₂ in RPMI after hyperbaric oxygen should be taken into account. Therefore, our data support a critical indication for the use of normobaric and hyperbaric oxygen and conscientious and careful handling of oxygen in everyday clinical practice. Full article

Cutaneous leishmaniasis is one of the most commonly diagnosed dermatological condition in travel medicine after diarrhoeal diseases and febrile status. The disease is transmitted by Phlebotomus and Lutzomyia sandflies. It appears in various clinical forms, the most common of which is a painless ulcer with raised edges, usually present on exposed parts of the body on the side where the insect bite occurred. Annually, over a million new cutaneous leishmaniasis (CL) cases are reported globally. We present two cases of affliction, the first occurring in Patient 1, who attempted treatment through the Kambo cleanse in South America, which is considered a toxic, even life-threatening, procedure. It involves the subcutaneous application of a substance dangerous to humans derived from the surface mucus of a frog. Patient 2 applied caustic ointments, a fruitarian diet, and hyperbaric oxygen therapy in a private setting. After initial therapeutic failures caused by the patients’ unconventional treatment ideas, the causal treatment effect was satisfactory, demonstrating the efficacy of these treatments in resolving the infection when applied appropriately. Despite the typical CL presentation in both patients, their self-treatment course was unusual. It is worth noting that alternative, sometimes harmful, self-treatment initiatives by patients may be surprising and ineffective. Promoting knowledge about tropical diseases among travellers and medical staff is crucial to improving treatment outcomes. Full article

Background: Sickle cell disease is the most common human monogenetic disease, and its risks are amplified during pregnancy. Methods: This report describes a 35-year-old woman with HgbSS sickle cell disease who developed hyperhemolysis syndrome after undergoing an exchange transfusion during pregnancy. Results: In addition to conventional medical treatment, the patient received prepartum hyperbaric oxygen therapy (HBOT), totaling 17 treatments for the indication of severe anemia. She experienced significant clinical improvement while undergoing HBOT and ultimately delivered a healthy preterm infant by cesarean section. Conclusions: The risks, benefits, and challenges of using HBOT in this unique context are discussed. Full article