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Objective: To provide an update on the status of provider participation in the US Wound Registry (USWR) and its speci- alty registry the Hyperbaric Oxygen Therapy Registry (HBOTR), which provide much-needed national benchmarking and quality measurement services for hyperbaric medicine. Methods: Providers can meet many requirements of the Merit-Based Incentive Payment System (MIPS) and simultaneously participate in the HBOTR by transmitting Continuity of Care Documents (CCDs) directly from their certified elec- tronic health record (EHR) or by reporting hyperbaric quality measures, the specifications for which are available free of charge for download from the registry website as electronic clinical quality measures for ..
Taking into consideration that a high concentration of oxygen can express toxic effects due to production of reactive oxygen species (ROS), the aim of our investigation was to establish the influence of hyperbaric oxygenation on oxidative stress parameters and antioxidant enzymes in patients with diabetes mellitus (DM) type 2. Investigation included50 patients with DM type 2 divided into two groups. The first group consisted of 25 patients, mean age 70 years, mean duration of illness 12 years and without manifest peripheral vascular complications (Wagner 0). The second group consisted of 25 patients, mean age 74 years, mean duration of ..
In the present study, a tympanometry-based anti-barotrauma (ABT) device was designed using eardrum admittance measurements to develop an objective method of preventing barotrauma that occurs during hyperbaric oxygen (HBO2) therapy. The middle ear space requires active equalization, and barotrauma of these tissues during HBO2 therapy constitutes the most common treatment-associated injury. Decongestant nasal sprays and nasal steroids are used, but their efficacy is questionable to prevent middle ear barotrauma (MEB) during HBO2 treatment. Accordingly, a tympanometry-based ABT device was designed using eardrum admittance measurements to develop an objective method for preventing MEB, which causes pain and injury, and represents one of the ..
Introduction: Necrosis, wound breakdown, and infection represent major complications associated with radical vulvectomy. We aimed to analyze the feasibility of hyperbaric oxygen (HBO2) therapy as an adjunctive treatment for such complica- tions. Methods: We performed a retrospective analysis of the medical records, clinical charts, and operative records of vulvar cancer patients who underwent hyperbaric oxygen therapy after extensive surgical resection in our institute between 2012 and 2016, with a comparison of the clinical outcomes of patients with similar surgical procedures and severe wound complications who did not undergo HBO2. Results: A total of 16 patients were included in the study. In the subgroup treated ..
Introduction: The Republic of China Navy instituted the pressure test as one of the selection tools for diving troops and submarine crews. We analyzed factors associated with failure in the pressure test. Methods: This was a retrospective cohort study designed to investigate pressure test failure in Navy recruits between January 2010 and August 2015. The recruits received pressurization in a hyperbaric chamber to a simulated depth of 112 feet of seawater (fsw) at a rate of 25 fsw/minute. Data describing trainee demographics, disease history, causes and depth of failure, as well as type of injury, were extracted from case notes and facility ..
Background: Decompression sickness (DCS) is a rare condition that is often difficult to diagnose in deep-sea divers. Because of this, prevention and early diagnosis are important. In this case-control study, we examined the risk and preventive factors associated with DCS. Methods: Our original questionnaire survey was conducted among 269 recreational divers in Okinawa. Divers who were diagnosed with DCS by a physician (n = 94) were compared with healthy recreational divers (n = 175). The questionnaire consisted of 30 items and included a dive profile. Odds ratios and multiple logistic regression analysis were used to estimate the relative risk of DCS. Results: Logistic regression analysis revealed the following risk ..
Purpose: This study evaluated the influence of hyperbaric exposure chambers on selected parameters of oxidative stress in divers’ blood. Methods: 25 healthy men (non-smoking experienced divers) ages 18-40 took part in the experiment. Subjects were exposed to hyperbaric conditions similar to those at 30 meters of depth while diving. A control group consisted of 20 healthy men who have never dived or been exposed to hyperbaric conditions. Blood was drawn from the cubital vein after overnight fasting. Superoxide dismutase (SOD-1) activity and malondialdehyde (MDA) concentration were marked in red blood cells (RBCs), carbonyl group concentration marked in serum proteins, and nitrate/nitrite concentrations ..
A number of competitive water sports are performed while breath-holding (apnea). Such performances put large demands on the anaerobic system, but the study of lactate accumulation in apneic sports is limited. We therefore aimed to determine and compare the net lactate accumulation (NLA) during com- petition events in six disciplines of competitive freediving (FD) and three disciplines of synchronized swimming (SSW). The FD disciplines were: static apnea (STA; n = 14); dynamic apnea (DYN; n = 19); dynamic apnea no fins (DNF; n = 16); constant weight no fins (CNF; n = 8); free immersion (FIM; n =10) The SSW disciplines were solo (n = ..
Introduction: Numerous reports have documented cervicocranial artery dissection (CCAD) associated with scuba diving. The question remains as to whether there are risk factors unique to scuba diving related to the occurrence of CCAD. Objectives: This article aims to perform an examination of the reported cases to demonstrate any commonality among the injured divers and association with known risk factors for CCAD. Methods: A PubMed search was performed utilizing the key words: carotid artery dissection, dissection, arterial dissection, cranial artery dissection, scuba, diving, scuba diving. Articles including reports, reviews, trials, case series, and letters were considered. Each report was critically dissected for information specific to the ..
Introduction: In April 2016 the Association of Diving Contractors International (ADCI) consensus guidelines began recommending annual cardiovascular risk stratification of commercial divers using the Framingham Risk Score (FRS). For those at elevated risk, further testing is recommended. This approach has raised concerns about potential operational and financial impacts. However, the prevalence of elevated cardiovascular risk and need for additional testing among commercial divers is not known. Methods: Clinical data required to calculate the FRS was ab- stracted for 190 commercial divers in two cohorts. Population demographics, FRS distribution, contributions of risk factors and effect of interventions on reducing risk-factor burden were assessed. Results: Mean ..
Neuropsychiatric sequelae have been reported in 15%-45% of survivors of carbon monoxide (CO) poisoning. Hyperbaric oxygen (HBO2) therapy reduces the incidence of cognitive and neurological a dysfunction. The efficacy of providing HBO2 beyond the first one to two days after initial insult is unknown. However, some evidence exists for the benefit of this treatment. We report on treating a patient 14 months after CO injury, who responded with markedly improved neurologic status. A 27-year-old scholar was found comatose due to CO poison- ing (carboxyhemoglobin = 31.7%). He received five acute HBO2 treatments. After discharge, he developed chorea, Parkinsonism, dystonia, memory loss, slowed ..
Introduction: Left-ventricular assist devices (LVAD) are becoming a common therapy for end-stage heart failure. These devices are not tested for pressurization in a hyperbaric chamber by the manufacturer. In this article, we present an approach to modify the power supply in order to safely treat a patient with an LVAD. Materials and methods: Our patient had a HeartMate IITM LVAD and presented for hyperbaric oxygen treatments for severe radiation cystitis. In order to modify this patient’s equipment to be compliant with NFPA6 safety standards we made several modifications. In brief, this included eliminating the usage of lithium-ion batteries, modifying the cord to be ..
The vast clinical manifestations of carbon monoxide (CO) poisoning can involve the neurological, neuropsychological and cardiac systems as well as others. In this case report, we describe our management of a 64-year-old woman exposed to CO in her apartment. Her presentation was unusual in that she had symmetric globus pallidus lesions, no evidence of thrombosis, but the lateralizing neurologic manifestation of severe hemiplegia. DOI: 10.22462/01.02.2018.13
Objective: This case report presents a patient with central retinal artery occlusion (CRAO) who was successfully treated with hyperbaric oxygen (HBO2) but subsequently suffered a recurrence of his visual loss. Methods: CRAO may be treated successfully with HBO2  if treatment is undertaken promptly after the onset of vision loss. The goal ofHBO2 therapy is to oxygenate the ischemic inner retinal layers via diffusion from the hyperoxygenated choroidal circulation until recanalization of the central retinal artery occurs. Results: A 71-year-old man presented with hand motion vision and fundus findings of CRAO in his left eye. Treatment with HBO2 was initiated approximately 9.5 hours after loss of vision. ..
[book review] DOI: 10.22462/01.02.2018.15