Ischemic wounds unresponsive to standard treatment in thromboangiitis obliterans are associated with amputation, morbidity, and mortality. In this study, hyperbaric oxygen therapy was added to standard treatment of 36 patients with thromboangiitis obliterans with ischemic ulcerated wounds in the extremities. Full recovery was observed in 52.7% of cases (25% at discharge, 27.7% during follow-up). Resting pain after treatment decreased significantly compared to pretreatment levels based on visual analog scale scores (7.1 ± 1.7 vs 2.2 ± 3.0, P = .0001). Mean wound area also decreased significantly after treatment (22.6 ± 17.5 vs 13.02 ± 16.5, P = .0001). The number of patients requiring no assistance during routine daily activities increased significantly (25% vs 55.5%, P = .001). All patients were at Fontaine stage IV before hyperbaric oxygen therapy. The number of patients at stage IIB increased significantly after treatment, while that of patients at stage IV decreased significantly (0% vs 47.2%, P = .0001, and 100% vs 47.2%, P = .0001, respectively). None of our patients was able to walk without pain before treatment; however, walking distance was significantly extended in 16 patients who were capable of walking (0 vs 190.6 ± 129.4 meters, P = .0001). In addition, 11.1% of patients underwent major amputation during follow-up.

AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modifi ed albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6). Intracranial pressure elevation and brain death were constituted with the infl ation of a balloon of a Fogarty catheter in the epidural space. In all three groups, blood samples were drawn before the procedure, and at minutes 150 and 240 for IMA and malondialdehyde (MDA) analysis. RESULTS: Serum IMA levels at 150 and 240 minutes were higher in ICPG than in CG (p < 0.05). IMA levels were similar in ICPG and BDG. Serum MDA levels at 150 and 240 minutes increased in ICPG and BDG groups compared to CG (p < 0.05). MDA levels were similar in ICP and BD groups. CONCLUSION: IMA should be considered as a biochemical parameter in the process starting from increased intracranial pressure elevation and ending at brain death (Tab. 3, Fig. 5, Ref. 31). Text in PDF www.elis.sk. KEY WORDS: ischemic modifi ed albumin, increased intracranial pressure, brain death.

Objective: Paraoxonase1 (PON1) and Arylesterase (ARE) levels are associated with reduced risk of atherosclerosis. The functional status of high density lipoprotein (HDL) is closely related to the PON1/ARE enzyme activity. Functional changes in treatment of sudden sensorineural hearing loss (SSNHL) may be achieved by post-translational modification of lipid metabolism induced by hyperbaric oxygen therapy (HBOT).Methods: Men patients with SSNHL who met the research criteria were included in the study. HBOT was performed on average 30 sessions. Laboratory measurements were made at the beginning and end of HBOT for the same patients. Serum levels of PON1/ARE and routine lipid laboratory parameters were measured to determine possible changes in SSNHL after HBOT.Results: In this study, a reducing effect on PON1 enzyme amount of long-term HBOT was detected. The serum PON1 amount of patients with SSNHL was 19.7 ± 2.7 ng / mL (mean ± SD) before HBOT, and the serum PON1 decreased to 17.0 ± 2.1 ng / mL (mean ± SD) after 30 sessions of HBOT. This decrease in PON1 levels was statistically significant (p =0.035). There was also a statistically significant decrease in the enzyme activity of ARE in the SSNHL patients (p=0.024).Conclusion: This preliminary study showed a significant decrease in serum PON1/ARE enzyme content in SSNLH patients with HBOT. In fact, it can be assumed that HBOT has no adverse effect on HDL functionality. However, the decrease in PON1 level by HBOT with 30 or more sessions may be important for the antioxidant function of HDL.It may possibly cause post-translational changes in antioxidant defense mechanisms due to increased oxidative stress with HBOT. In conclusion, larger clinical studies are needed to determine the possible effects of HBOT on HDL-related PON1/ARE functionality in SSNHL.

The addition of HBOT to conventional treatment in TAO patients with non-healing ischaemic wounds and severe extremity pain, conferred significant benefits in terms of wound healing and rest pain control. Multi-centre, prospective, randomized studies with blinded outcome analysis are now needed to elicit more reliable results.

Hyperbaric oxygen (HBO) treatment is generally a relatively safe therapy for various conditions. However, there are some adverse side effects. For example HBO tratment has been reported to increase the production of free oxygen radicals(FRs). Furthermore, to our knowledge, no previous clinical research has been carried out to study the involvement of platelet-activating factor(PAF)as the lipid oxidative stressor in patients undergoing HBO treatment. A total of 45 patients included in this study were first given clinical assessment and laboratory measurements before starting HBO treatment and were named group baseline. After the HBO treatment, the same clinical and laboratory measurements from the same patients were repeated and this was named group sesion >20.As expected, long-term HBO treatment had no effect on oxLDL (oxidized low-density lipoprotein), a lipid oxidative stress(OS) marker. However, the mean PAF values in the second group showed a statistically significant increase compared to their pretreatment values, (P <0. 002).As this is a preliminary study, there is a need for more detailed investigations that demonstrate the association of HBO treatment with the lipid inflammatory response. Therefore, there is need for further clinical study for OS markers such as oxLDL in HBO treatment. Clinical prospective studies are required to confirm our laboratory findings.

Objective: Carbon monoxide (CO) is the main cause of intoxication-related mortality and morbidity in developed countries. It is responsible for more than half of fatal intoxications in many countries. The purpose of this study was to determine the diagnostic value of protein carbonyl (PC), a good marker of oxidative stress, in association with oxidative stress resulting from hypoxia emerging in patients with acute CO intoxication. Methods: Thirty-four patients diagnosed with acute CO intoxication at the Emergency Department and 38 healthy volunteers were included in the study. Patients' PC levels at time of admission and after treatment were compared with those of a control group. Results: No statistically significant difference was observed among PC levels at time of admission in the patient and control groups (p =0.305, patient group 0.025 ± 0.01, control group 0.026 ± 0.01). A significant decrease was determined in post-treatment PC levels in the patient group compared to those at time of admission (p = 0.006, admission 0.025 ± 0.01, post-treatment 0.017 ± 0.008). No significant correlation was determined between patients' carboxyhemoglobin (CO-Hb) levels and PC levels at time of admission (Correlation coefficient =-0.006, p= 0.971). Conclusions: We think that PC is not suitable for use as a biomarker in the acute period in patients with CO intoxication.

Objective: Carbon monoxide (CO) is the main cause of death and morbidity associated with poisoning in developed countries. The most important mortality and morbidity cause of CO poisoning is cerebral hypoxia. Near infrared spectroscopy (NIRS) is a useful method for assessing brain oxygenation. In this study, we aimed to evaluate the brain oxygenation of CO poisoning patients with NIRS and to investigate its benefits in patients follow up and treatment. Methods: The study was conducted as a single-center, prospective clinical trial with 33 patients who were diagnosed by measuring blood carboxyhemoglobin (CO-Hb) level or referred from other hospitals diagnosed with CO poisoning. Patients were divided into two groups as normobaric oxygen therapy (NBOT) group and hyperbaric oxygen therapy (HBOT) group according to the treatment method applied. Results: Although average cerebral saturation (ScO2) levels after treatment were higher in the NBOT group than before treatment, no statistically significant difference was found except the left frontal ScO2 values. In HBOT group, there was no difference between ScO2 values before and after treatment sessions. Conclusions: Our study concluded that NIRS may be useful in assessing brain oxygenation in CO poisoned patients, but not in determining the HBOT start-up, and not in monitoring the effectiveness of HBOT.

The efficiency of hyperbaric oxygen (HBO) treatment according to ABO blood group system was evaluated in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). Serum lipid values and novel atherogenic risk calculations of 346 patients who came to the clinic for HBO treatment were performed. HBO treatment efficiency was evaluated on ABO blood groups. The effect of serum lipid levels and atherogenic risk levels on HBO treatment was measured according to the blood groups of ISSNHL patients. The most important finding is that ISSNHL patients with O blood group antigen benefit the least from HBO therapy. Moreover, patients with O blood group antigen had statistically lower serum lipid values and atrogenic risk index than patients with non-O blood group. In addition, the frequency of O blood group in ISSNHL patients was higher than in non-O blood groups. The effect of serum lipid values and atherogenic risk indices in ISSNHL patients receiving HBO therapy may vary according to ABO blood groups. The relationship between hyperbaric oxygen therapy and the ABO blood grouping system should be supported by further research.