Can hyperbaric oxygenation decrease doxorubicin hepatotoxicity and improve regeneration in the injured liver?
MED Â Â 09-27 Â Â 200919288285Â Â NDN- 230-0963-0060-6
AUTHORS- Firat, Ozgur; Kirdok, Ozgur; Makay, Ozer; Caliskan, Cemil; Yilmaz, Funda; Ilgezdi, Savas; Karabulut, Bulent; Coker, Ahmet; Zeytunlu, Murat
JOURNAL NAME- J Hepatobiliary Pancreat Surg
VOLUME 16
NUMBER 3
PUBLICATION DATE- 2009
PP 346-52
DOCUMENT TYPE- Journal Article
JOURNAL CODE- 9431940
JOURNAL SUBSET- MEDJSIM
ISSN- 1436-0691
CORPORATE AUTHOR- Department of General Surgery, Ege University Hospital, 3rd Floor, Bornova, 35100, Izmir, Turkey. ozgur.firat@ege.edu.tr
PUBLICATION COUNTRY- Japan
LANGUAGE- English
BACKGROUND/PURPOSE: Portal vein embolization is used in the treatment of hepatocellular cancer, with the purpose of enhancing resectability. However, regeneration is restricted due to hepatocellular injury following chemotherapeutics (e.g. doxorubicin). The aim of this study was to investigate whether hyperbaric oxygenation (HBO) can alleviate the hepatotoxicity of chemotherapy and improve regeneration in the injured liver.
METHODS: Rats were allocated to four experimental groups. Group I rats were subjected to right portal vein ligation (RPVL); rats in groups II and III were administered doxorubicin prior to RPVL, with group III rats being additionally exposed to HBO sessions postoperatively; group IV rats was sham-operated. All rats were sacrificed on postoperative day 7, and liver injury was assessed by measuring alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Protein synthetic ability was determined based albumin levels and liver regeneration by the mitotic index (MI).
RESULTS: The AST and ALT values of group II rats were significantly higher than those of group I, but not those of group III. Rats treated with doxorubicin and HBO (groups II and III) showed slightly but not significant differences in albumin levels than those subjected to only RPVL or sham-operated. The MI was significantly increased in groups I, II, and III, with the MI of group III rats significantly higher than those of group I rats.
CONCLUSIONS: Based on our results, we conclude that HBO treatment has the potential to diminish doxorubicin-related hepatotoxicity and improve regeneration in the injured liver.
*HBO and doxorubicin given together has caused death in rats (probably from cardiac toxicity), and cisplatin with HBO weakens the tensile strength of healing wounds in mice.
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Carbon monoxide poisoning
MED Â Â 09-28 Â Â 200919416624Â Â NDN- 230-0966-3698-3
AUTHORS- Sinding, Marianne; Friis-Mooller, Nina
JOURNAL NAME- Ugeskr Laeger
VOLUME 171
NUMBER 15
PUBLICATION DATE- 2009 Apr 6
PP 1298
DOCUMENT TYPE- English Abstract; Journal Article
JOURNAL CODE- 0141730
JOURNAL SUBSET- MEDJSIM
ISSN- 1603-6824
CORPORATE AUTHOR- Roskilde Sygehus, Medicinsk Afdeling. mariannesinding@dadlnet.dk
PUBLICATION COUNTRY- Denmark
LANGUAGE- Danish
Carbon monoxide (CO) is a colourless, smell free, toxic gas. CO poisoning is treated by the administration of 100% oxygen, and in some cases by the administration of hyperbaric oxygen (HBO). In Denmark, 250-325 cases of CO poisoning are treated annually, of which a few percent receive HBO. However, there are discrepancies between the various current guidelines for the treatment of CO poisoning, in particular with respect to the indication for HBO. We describe the treatment of CO poisoning in a family of six members exposed to CO from indoor barbecuing.
See also:
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Web page describing the risks of CO poisoning and diving.
www.scuba-doc.com/carbonmon.html - 23k - Cached - Similar pages
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I’m not aware of any studies relating to CO ( carbon monoxide) retention but it certainly is a consideration in not smoking just before diving. …
scuba-doc.com/smkndvng.htm - 32k - Cached - Similar pages
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Carbon monoxide poisoning. Early awareness and intervention can save lives. … Carbon monoxide poisoning and treatment with hyperbaric oxygen in the …
www.scuba-doc.com/HBOref.html - 35k - Cached - Similar pages
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Carbon monoxide poisoning is a rare cause of problems when diving, it does occur … Carbon monoxide in diving is the product of incomplete combustion of …
www.scuba-doc.com/carbmon.htm - 11k - Cached - Similar pages
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hyperbaric oxygen in suspected carbon monoxide poisoning. JAMA. … of normobaric and hyperbaric oxygen for acute carbon monoxide intoxication. Lancet. …
www.scuba-doc.com/hbotrtmnt.html - 92k - Cached - Similar pages
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Influence of surgical treatment timing on mortality from necrotizing soft tissue infections requiring intensive care management.
MED Â Â 09-27 Â Â 200919099288Â Â NDN- 230-0964-1476-1
AUTHORS- Boyer, Alexandre; Vargas, Frederic; Coste, Fanny; Saubusse, Elodie; Castaing, Yves; Gbikpi-Benissan, Georges; Hilbert, Gilles; Gruson, Didier
JOURNAL NAME- Intensive Care Med
VOLUME 35
NUMBER 5
PUBLICATION DATE- 2009 May
PP 847-53
DOCUMENT TYPE- Journal Article
JOURNAL CODE- 7704851
JOURNAL SUBSET- MEDJSIM
ISSN- 1432-1238
CORPORATE AUTHOR- Medical Intensive Care Unit, Ho.pital Pellegrin-Tripode, Place Amoelie Raba Loeon, 33076 Bordeaux cedex, France. alexandre.boyer@chu-bordeaux.fr
PUBLICATION COUNTRY- United States
LANGUAGE- English
PURPOSE: Surgical treatment is crucial in the management of necrotizing soft tissue infections (NSTIs). The aim of this study was to determine the influence of surgical procedure timing on hospital mortality in severe NSTI.
METHODS: A retrospective study including 106 patients was conducted in a medical intensive care unit equipped with a hyperbaric chamber Data regarding pre-existing conditions, intensive care and surgical management were included in a logistic regression model to determine independent factors associated with hospital mortality.
RESULTS: Overall hospital mortality was 40.6%. In multivariate analysis, underlying cardiovascular disease, SAPS II, abdominoperineal compared to limb localization, time from the first signs to diagnosis <72 h, and time from diagnosis to surgical treatment >14 h in patients with septic shock were independently associated with hospital mortality.
CONCLUSION: In patients with NSTI and septic shock, hospital mortality is influenced by the timing of surgical treatment.
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Pre-dive normobaric oxygen reduces bubble formation in scuba divers.
MED Â Â 09-27 Â Â 200919219451Â Â NDN- 230-0964-1119-7
AUTHORS- Castagna, Olivier; Gempp, Emmanuel; Blatteau, Jean-Eric
JOURNAL NAME- Eur J Appl Physiol
VOLUME 106
NUMBER 2
PUBLICATION DATE- 2009 May
PP 167-72
DOCUMENT TYPE- Journal Article
JOURNAL CODE- 100954790
JOURNAL SUBSET- MEDJSIM
ISSN- 1439-6327
CORPORATE AUTHOR- Institute of Naval Medicine, BP 610, 83800, Toulon Army, France.
PUBLICATION COUNTRY- Germany
LANGUAGE- English
Oxygen pre-breathing is routinely employed as a protective measure to reduce the incidence of altitude decompression sickness in aviators and astronauts, but the effectiveness of normobaric oxygen before hyperbaric exposure has not been well explored. The objective of this study was to evaluate the effect of 30-min normobaric oxygen (O(2)) breathing before diving upon bubble formation in recreational divers.
Twenty-one subjects (13 men and 8 women, mean age (SD) 33 +/- 8 years) performed random repetitive open-sea dives (surface interval of 100 min) to 30 msw for 30 min with a 6-min stop at 3 msw under four experimental protocols: “air-air” (control), “O(2)-O(2)”, “O(2)-air” and “air-O(2)” where “O(2)” corresponds to a dive with oxygen pre-breathing and “air” a dive without oxygen administration. Post-dive venous gas emboli were examined by means of a precordial Doppler ultrasound.
The results showed decreased bubble scores in all dives where preoxygenation had taken place (p < 0.01). Oxygen pre-breathing before each dive (“O(2)-O(2)” condition) resulted in the highest reduction in bubble scores measured after the second dive compared to the control condition (-66%, p < 0.05). The “O(2)-air” and “air-O(2) “conditions produced fewer circulating bubbles after the second dive than “air-air” condition (-47.3% and -52.2%, respectively, p < 0.05) but less bubbles were detected in “air-O(2) “condition compared to “O(2)-air” (p < 0.05).
Our findings provide evidence that normobaric oxygen pre-breathing decreases venous gas emboli formation with a prolonged protective effect over time. This procedure could therefore be beneficial for multi-day repetitive diving.
* It has not been shown that reduction in VGE provides a decrease in decompression sickness. Reference the Deep Stop workshop held at the UHMS meeting last June
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Surgical debridement and adjunctive hyperbaric oxygen in cervical necrotizing fasciitis.
MED Â Â 09-27 Â Â 200919393420Â Â NDN- 230-0962-5077-7
AUTHORS- Flanagan, Carrie E; Daramola, Opeyemi O; Maisel, Robert H; Adkinson, Cher; Odland, Rick M
JOURNAL NAME- Otolaryngol Head Neck Surg
VOLUME 140
NUMBER 5
PUBLICATION DATE- 2009 May
PP 730-4
DOCUMENT TYPE- Journal Article
JOURNAL CODE- 8508176
JOURNAL SUBSET- MEDJSIM
ISSN- 0194-5998
CORPORATE AUTHOR- University of Minnesota Medical School, Hennepin County Medical Center, Minneapolis, MN; Department of Otolaryngology-Head and Neck Surgery, Hennepin County Medical Center, Minneapolis, MN.
PUBLICATION COUNTRY- United States
LANGUAGE- English
OBJECTIVE: To review our management of cervical necrotizing fasciitis (CNF) with the use of adjunctive hyperbaric oxygen therapy (HBO).
STUDY DESIGN: Case series with chart review.
SUBJECTS AND METHODS: Evaluation of ten patients with CNF between 2001 to 2006.
RESULTS: There were five male and six female patients. Mean age was 43 +/- 11 years. Eight cases resulted from an odontogenic source. Comorbidities included diabetes mellitus, hypertension, and substance abuse. All patients had computed tomography scans performed, received intravenous antibiotics, and underwent surgical debridement. Eight patients underwent surgery within 24 hours. The average number of debridements was 2.2 +/- 0.8. Hospitalization was twice as long for diabetic patients (15.5 +/- 8.16 days) compared with nondiabetic patients (7.5 +/- 1.6 days, P = 0.029). Nine patients had HBO therapy. Combined data revealed a possible decrease in length of hospitalization with HBO therapy (P < 0.001). No mortality was documented.
CONCLUSION: In addition to early and aggressive medical management and surgical debridement, this study suggests that HBO therapy is a beneficial adjunct by potentially decreasing length of hospitalization. Randomized trials are still needed to demonstrate its efficacy.
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Treatment of radiation retinopathy following plaque brachytherapy for choroidal melanoma.
MED Â Â 09-28 Â Â 200919349865Â Â NDN- 230-0966-2802-2
AUTHORS- Wen, Joanne C; McCannel, Tara A
JOURNAL NAME- Curr Opin Ophthalmol
VOLUME 20
NUMBER 3
PUBLICATION DATE- 2009 May
PP 200-4
DOCUMENT TYPE- Journal Article
JOURNAL CODE- 9011108
JOURNAL SUBSET- MEDJSIM
ISSN- 1531-7021
CORPORATE AUTHOR- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7000, USA.
PUBLICATION COUNTRY- United States
LANGUAGE- English
PURPOSE OF REVIEW: Radiation retinopathy and maculopathy are predictable complications resulting from exposure to any source of radiation, including external beam and plaque brachytherapy. Most choroidal melanomas are currently treated with plaque brachytherapy. However, the ensuing complications frequently compromise posttreatment vision. The purpose of this review is to discuss recent studies on the management of radiation retinopathy and maculopathy.
RECENT FINDINGS: Intravitreal bevacizumab, intravitreal triamcinolone and laser photocoagulation appear to transiently decrease macular edema, although improvements in visual acuity are limited. In successful studies, recurrent treatments were needed to sustain the effects. Case studies of photodynamic therapy, oral pentoxyphylline and hyperbaric oxygen treatment describe positive results, but further studies are required. One study suggests that laser photocoagulation may be useful in prophylactically treating radiation retinopathy.
SUMMARY: Currently, there are no proven treatments for radiation retinopathy or maculopathy. The current treatment methods require frequent administration with variable improvement in visual acuity.
Ern Campbell, MD
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