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Treatment of pediatric cerebral radiation necrosis using hyperbaric oxygenation. 高压氧治疗小儿脑放射性坏死。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-04-01
Kelly Johnson-Arbor

Introduction: Cerebral radiation necrosis is rarely encountered in pediatric patients. This case report describes a child with cerebral radiation necrosis who was successfully treated using corticosteroids, bevacizumab, and hyperbaric oxygenation.

Case report: A 3-year-old boy developed progressive extremity weakness six months after the completion of radiation therapy for the treatment of a neuroepithelial malignancy. Treatment with corticosteroids and bevacizumab was initiated, but his symptoms did not improve, and he was then referred for hyperbaric oxygen therapy. After completing 60 hyperbaric treatments, he experienced significant improvements in mobility, which remained stable over the next year.

Discussion: Cerebral radiation necrosis typically presents in children with symptoms of ataxia or headache. Corticosteroids and bevacizumab are common treatments, but hyperbaric oxygen therapy has also been studied as a therapeutic modality for this condition. When considering the use of hyperbaric oxygenation in pediatric patients, careful attention to treatment planning and patient safety can reduce the risks of adverse events such as middle ear barotrauma and confinement anxiety.

Conclusion: In addition to other available pharmacologic therapies, hyperbaric oxygenation should be considered for the treatment of pediatric patients with cerebral radiation necrosis.

儿童患者很少遇到脑放射性坏死。本病例报告描述了一个使用皮质类固醇、贝伐单抗和高压氧成功治疗脑放射性坏死的儿童。病例报告:一名3岁男孩在完成神经上皮恶性肿瘤的放射治疗6个月后出现进行性四肢无力。开始使用皮质类固醇和贝伐单抗治疗,但他的症状没有改善,随后他被转介进行高压氧治疗。在完成60次高压氧治疗后,他的行动能力有了显著改善,并在接下来的一年里保持稳定。讨论:脑放射性坏死通常表现为儿童共济失调或头痛的症状。皮质类固醇和贝伐单抗是常见的治疗方法,但高压氧治疗也被研究作为这种疾病的治疗方式。在儿科患者中考虑使用高压氧时,仔细注意治疗计划和患者安全,可以降低中耳气压伤和禁闭焦虑等不良事件的风险。结论:在其他药物治疗方法的基础上,高压氧治疗可作为儿童脑放射性坏死的治疗方法。
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引用次数: 0
Analysis of the cardiovascular effects of hyperbaric oxygen therapy in diabetic patients. 糖尿病患者高压氧治疗对心血管的影响分析。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-04-01
Kubra Canarslan-Demir, Kubra Ozgok-Kangal, Ayse Saatci-Yasar, Mehmet Akif Erdol, Bayram Koc

During hyperbaric oxygen (HBO2) therapy in humans, there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia, and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. In addition, cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may negatively affect cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, and electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc and QTc dispersion measurements (p≺0.001 and p = 0.02, respectively). In cardiac enzymes, there was a statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.3, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT, and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution in using HBO2 therapy in patients with DM and emphasize the need for further investigation of these measurements.

在人类高压氧(HBO2)治疗期间,由于高压和高氧,心血管生理学发生了变化。在HBO2治疗期间观察到外周血管收缩、心动过缓和心输出量减少。HBO2治疗对心血管系统的这些生理影响在健康人群中是可耐受的。然而,患有潜在心脏病的患者在HBO2治疗期间可能会遇到严重的问题,如肺水肿和死亡。此外,糖尿病(DM)患者还可能出现心脏并发症。因此,HBO2治疗可能会对糖尿病患者的心血管生理产生负面影响。本研究旨在探讨HBO2治疗对糖尿病患者心血管的影响。比较卫生部大学 lhane训练研究水下和高压氧医学诊所申请的糖尿病患者第一次HBO2治疗前后的NT-ProBNP、肌钙蛋白I和心电图(ECG)结果。当在HBO2暴露结束时分析心电图结果时,QTc和QTc弥散测量值有统计学意义上的显著增加(p = 0.001和p = 0.02)。在心脏酶方面,HBO2治疗后肌钙蛋白I升高有统计学意义,而Pro-BNP无统计学意义(p = 0.009, p = 0.3)。短期暴露于HBO2治疗对DM患者肌钙蛋白I、QT、QTc的改变有统计学意义,但未达到临床意义。尽管很少有心功能障碍的证据,但我们建议在糖尿病患者中谨慎使用HBO2治疗,并强调需要进一步研究这些测量值。
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引用次数: 0
Efficacy of hyperbaric oxygen after microtia reconstruction using costal cartilage: A retrospective case-control study. 用肋软骨重建小体缺损后高压氧的疗效:回顾性病例对照研究。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-04-01
Naoki Murao, Akihiko Oyama, Yuhei Yamamoto, Emi Funayama, Kosuke Ishikawa, Taku Maeda

Introduction: Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for the prevention of postoperative complications after framework grafting in microtia reconstruction.

Methods: We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015, according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day.

Results: During the study period, eight patients received HBO2 therapy after costal cartilage grafting, and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower, and the healing time was shorter in patients who received HBO2 therapy than in those who did not.

Discussion: HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.

自体肋软骨框架植入术重建耳小体是一项具有挑战性的手术,因为耳的三维结构非常复杂,而且很难满足患者的高审美要求。如果将覆盖在框架上的皮瓣变薄以获得光滑和突出的轮廓,薄皮瓣的血液供应不良可能导致皮肤坏死,框架暴露,手术效果不佳。高压氧(HBO2)治疗可促进复杂创面及皮瓣的愈合。本研究旨在确定HBO2治疗对小脑重建框架移植术后并发症预防的有效性。方法:我们回顾性评估2011年至2015年在本院接受肋软骨移植进行小体缺损重建术的儿童患者的术后并发症,并比较他们是否接受术后HBO2治疗的结果。HBO2治疗从术后第一天开始,每天1次,共10次。结果:研究期间肋软骨移植术后接受HBO2治疗8例,未接受HBO2治疗12例。两组术后溃疡发生率无显著差异。然而,与未接受HBO2治疗的患者相比,接受HBO2治疗的患者框架暴露的发生率更低,愈合时间也更短。讨论:HBO2治疗可以安全地用于儿科患者,减少术后并发症,改善小脑重建的美观效果。肋软骨移植术后,HBO2治疗可作为辅助治疗。
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引用次数: 0
Aerobic exercise performance is reduced following prolonged cold-water immersion. 长时间的冷水浸泡会降低有氧运动的表现。
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-04-01
Hayden W Hess, Zachary J Schlader, Blair D Johnson, Riana R Pryor, David Hostler

Background: We tested the hypotheses that self-paced aerobic exercise performance is reduced following four hours of cold-water immersion when breathing air and further reduced when breathing 100% oxygen (O2). Nine healthy adults (four women; age 24 ± 3 years; body fat 17.9 ± 6.4%; VO2max 48±9 mL • kg • minute⁻¹) completed three visits: a no-immersion control trial and two experimental trials consisting of a four-hour cold-water immersion (20.1±0.3°C) either breathing air (FIO2 = 0.21) or O2 (FIO2 = 1.0). During the no-immersion control trial and following immersion in the experimental trials, subjects first completed a 60-minute ruck-march carrying 20% of body mass in a rucksack, immediately followed by an unweighted, self-paced 5-km time trial on a motorized treadmill. Core temperature, heart rate, and rating of perceived exertion were recorded every 1,000 meters during the 5-km time trial. Data are presented mean± SD. Time trial performance was reduced following immersion in both the 100% O2 trial (32±6 minutes; p=0.01) and air trial (32±5 minutes; p=0.01) compared to the control trial (28± 4 minutes). However, there was no difference between the 100% O2 and air trials (p=0.86). Heart rate, core temperature, and rating of perceived exertion increased during the time trial (time effect: p≺0.01), but were not different between trials (trial effect: p≥0.33). These findings suggest that prolonged cold-water immersion attenuates self-paced aerobic exercise performance, but does not appear to be further affected by breathing gas type.

背景:我们测试了一种假设,即在呼吸空气的情况下,自定节奏的有氧运动表现在冷水浸泡4小时后会下降,在呼吸100%氧气(O2)时进一步下降。9名健康成年人(4名女性;年龄24±3岁;体脂17.9±6.4%;VO2max 48±9毫升•公斤•分钟⁻¹)完成三个访问:no-immersion控制试验和两个实验试验组成的冷水浸泡四小时(20.1±0.3°C)呼吸空气(供给= 0.21)或O2(供给= 1.0)。在无浸泡对照试验和浸泡后的实验试验中,受试者首先在背包中负重20%的体重完成60分钟的徒步旅行,紧接着在电动跑步机上进行无重量、自定节奏的5公里计时赛。在5公里计时赛中,每1000米记录一次核心温度、心率和感知运动等级。数据以均数±标准差表示。浸泡在100% O2试验中(32±6分钟;P =0.01)和空气试验(32±5分钟);P =0.01),与对照试验(28±4分钟)比较。然而,100% O2和空气试验之间没有差异(p=0.86)。计时赛期间心率、核心温度和感觉运动等级升高(时间效应:p{0.01}),但试验间无差异(试验效应:p≥0.33)。这些发现表明,长时间的冷水浸泡会降低自定节奏有氧运动的表现,但似乎不会受到呼吸气体类型的进一步影响。
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引用次数: 0
Hyperbaric oxygen combined with hydrogen-rich saline protect against acute lung in rat model 高压氧联合富氢盐水对大鼠急性肺模型的保护作用
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.22462/01.01.2023.5
Yin Chang, Qianyu Han, Xiao-chen Bao, Mingdong Wang, Yuxiang Jin, Siang Zhang, Xuewei Zhao, Yi-qun Fang, L. Xue
Background: To investigate therapeutic effects of hydrogen-rich saline (HRS) combined with hyperbaric oxygen (HBO2) in an experimental rat model of acute lung injury (ALI). Methods: 40 Male Sprague-Dawley rats were randomly divided into sham, LPS, LPS + HBO2, LPS + HRS and LPS + HBO2 + HRS groups. ALI was induced by an intratracheal injection of LPS, then the rats were respectively given single agent treatment of HBO2 or HRS or HBO2 + HRS treatment. The treatments were continued for three days in an experimental rat model of ALI. At the end of the experiment, the lung pathological, inflammatory factors, and cell apoptosis in the pulmonary tissue were detected by Tunel method and cell apoptosis rate was calculated accordingly. Results: In the groups treated with HBO2 + HRS, pulmonary pathological data, wet-dry weight ratio and inflammatory factors of pulmonary tissues and aveolar lavage fluid were signficantly superiror to those of the sham group (p<0.05). Cell apoptosis detection revealed that no matter single agent treatment of HRS or HBO2, or combination treatment, could all alleviate cell apoptosis, and HRS combined with HBO2 treatment was obviously superior to single treatment (p<0.05). Conclusions: HRS or HBO2 single treatment could decrease inflammatory cytokines release in lung tissue, reduce accumulation of oxidative products and alleviate apoptosis of pulmoanry cells, then lead to positive therapeutic effects on ALI induced by LPS. Furthermore, HBO2 combined with HRS treatment presented a synergy effect on cell apoptosis decrease, and a declined trend in inflammatory cytokines release and related inflammatory products generation, compared with single treatment.
背景:探讨富氢盐水(HRS)联合高压氧(HBO2)对实验性大鼠急性肺损伤(ALI)模型的治疗作用。方法:40只雄性Sprague-Dawley大鼠随机分为假组、LPS组、LPS + HBO2组、LPS + HRS组和LPS + HBO2 + HRS组。通过气管内注射LPS诱导大鼠ALI,然后分别给予HBO2或HRS单药治疗或HBO2 + HRS治疗。在ALI实验大鼠模型中持续治疗3天。实验结束时,采用Tunel法检测大鼠肺组织病理、炎症因子及细胞凋亡情况,并计算细胞凋亡率。结果:HBO2 + HRS治疗组肺病理指标、肺组织及肺泡灌洗液的干湿比、炎性因子均显著优于假手术组(p<0.05)。细胞凋亡检测结果显示,无论是HRS或HBO2单药治疗,还是联合治疗,均能减轻细胞凋亡,且HRS联合HBO2治疗明显优于单药治疗(p<0.05)。结论:HRS或HBO2单药治疗可降低肺组织炎症因子释放,减少氧化产物积累,减轻肺细胞凋亡,对LPS诱导的ALI有积极的治疗作用。此外,与单独治疗相比,HBO2联合HRS治疗对细胞凋亡减少具有协同作用,炎症因子释放和相关炎症产物生成呈下降趋势。
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引用次数: 0
Efficacy of hyperbaric oxygen after microtia reconstruction using costal cartilage: A retrospective case-control study 用肋软骨重建小体缺损后高压氧的疗效:回顾性病例对照研究
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.22462/01.01.2023.46
N. Murao, A. Oyama, Yuhei Yamamoto, E. Funayama, K. Ishikawa, T. Maeda
Introduction: Microtia reconstruction with autologous costal cartilage framework grafting is challenging because the three-dimensional structure of the ear is highly complex, and meeting the high aesthetic demands of patients can be difficult. If the skin flap overlying the framework is thinned to achieve a smooth and accentuated outline, a poor blood supply in the thin skin flap may lead to skin necrosis, exposure of the framework, and poor surgical results. Hyperbaric oxygen (HBO2) therapy can promote the healing of complex wounds and flaps. This study sought to determine the effectiveness of HBO2 therapy for prevention of postoperative complications after framework grafting in microtia reconstruction. Methods: We retrospectively evaluated postoperative complications and compared outcomes in pediatric patients who underwent costal cartilage grafting for microtia reconstruction at our institution between 2011 and 2015 according to whether or not they received postoperative HBO2 therapy. HBO2 therapy was applied once daily for a total of 10 sessions starting on the first postoperative day. Results: During the study period, eight patients received HBO2 therapy after costal cartilage grafting and 12 did not. There was no significant difference in the incidence of postoperative ulcers. However, the incidence of framework exposure was lower and the healing time was shorter in patients who received HBO2 therapy than in those who did not. Discussion: HBO2 therapy can be used safely in pediatric patients to reduce postoperative complications and improve the aesthetic outcome of microtia reconstruction. After costal cartilage grafting, HBO2 therapy should be considered as adjuvant therapy.
自体肋软骨框架植入术重建耳小体是一项具有挑战性的手术,因为耳的三维结构非常复杂,而且很难满足患者的高审美要求。如果将覆盖在框架上的皮瓣变薄以获得光滑和突出的轮廓,薄皮瓣的血液供应不良可能导致皮肤坏死,框架暴露,手术效果不佳。高压氧(HBO2)治疗可促进复杂创面及皮瓣的愈合。本研究旨在确定HBO2治疗对小脑重建框架移植术后并发症预防的有效性。方法:我们回顾性评估2011年至2015年在我院接受肋软骨移植进行小体缺损重建术的儿童患者的术后并发症,并比较其术后是否接受HBO2治疗的结果。HBO2治疗从术后第一天开始,每天1次,共10次。结果:研究期间,肋软骨移植术后接受HBO2治疗8例,未接受HBO2治疗12例。两组术后溃疡发生率无显著差异。然而,与未接受HBO2治疗的患者相比,接受HBO2治疗的患者框架暴露的发生率更低,愈合时间更短。讨论:HBO2治疗可以安全地用于儿科患者,减少术后并发症,改善小脑重建的美观效果。肋软骨移植术后,HBO2治疗可作为辅助治疗。
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引用次数: 0
Jin
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.1007/978-3-540-72816-0_12087
Yin Chang, Qianyu Han, Xiao-chen Bao, Mingdong Wang, Yuxiang Jin, Siang Zhang, Xuewei Zhao, Yiqun Fang, L. Xue
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引用次数: 0
Analysis of the cardiovascular effects of hyperbaric oxygen therapy in diabetic patients 糖尿病患者高压氧治疗对心血管的影响分析
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.22462/01.01.2023.6
K. Canarslan-Demir, Kubra Ozgok-Kangal, Ayse SAATCI-YASAR, M. A. Erdol, B. Koç
During hyperbaric oxygen (HBO2) therapy in humans there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. Cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may have negative effects on cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc, QTc dispersion measurements (p < 0.001, p = 0.015, respectively). In cardiac enzymes there was statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.300, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution HBO2 therapy in patients with DM and the need for further investigation of these measurements.
在人类高压氧(HBO2)治疗期间,由于高压和高氧,心血管生理学发生了变化。在HBO2治疗期间观察到外周血管收缩,心动过缓和心输出量减少。HBO2治疗对心血管系统的这些生理影响在健康人群中是可耐受的。然而,患有潜在心脏病的患者在HBO2治疗期间可能会遇到严重的问题,如肺水肿和死亡。糖尿病(DM)患者可能出现心脏并发症。因此,HBO2治疗可能会对糖尿病患者的心血管生理产生负面影响。本研究旨在探讨HBO2治疗对糖尿病患者心血管的影响。比较卫生部大学 lhane训练研究水下和高压氧医学诊所申请的糖尿病患者第一次HBO2治疗前后NT-ProBNP、肌钙蛋白I、心电图(ECG)的变化。当分析HBO2暴露结束时的心电图结果时,观察到QTc和QTc弥散度测量有统计学意义的增加(p < 0.001, p = 0.015)。心肌酶方面,HBO2治疗后肌钙蛋白I升高有统计学意义,而Pro-BNP变化无统计学意义(p = 0.009, p = 0.300)。短期暴露于HBO2治疗对DM患者肌钙蛋白I、QT、QTc的影响有统计学意义,但未达到临床意义。尽管很少有心功能障碍的证据,但我们建议糖尿病患者谨慎使用HBO2治疗,并需要进一步研究这些测量值。
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引用次数: 0
Lethal event in scuba diving with self-contained breathing apparatus: a forensic study 带独立呼吸器的水肺潜水中的致命事件:一项法医研究
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.22462/01.01.2023.10
Mirko Leonardelli, F. Mele, M. Calvano, Enrica Macorano, Stefano Duma, Giovanni De Gabriele, F. Introna
Introduction: In fatal accidents during scuba diving it is necessary to differentiate a death from primary drowning from a secondary drowning death primarily due to other etiopathogenetic factors. The inhalation of water can only be the end point of a series of events alone capable of causing the diver’s exitus. The aim of this study is demonstrate that even low-risk heart diseases in daily life become potentially fatal during scuba diving. Methods: In this case series we describe all cases of death in the course of diving that came to the observation of the Forensic Institute of the University of Bari over a period of 20 years (2000-2020). Judicial autopsy was performed on all subjects with ancillary execution of histological and toxicological investigations. Results: The results of the medicolegal investigations carried out in the complex identified heart failure with acute myocardial infarction as the cause of death in four cases characterized by severe myocardiocoronarosclerosis, a primary drowning in a subject without previous pathological substrate in one case, and a terminal atrial fibrillation induced by acute dynamic heart failure due to functional overload of the right ventricle in one case Conclusion: Our study demonstrates that lethal events during diving are often related to the presence of unrecognized or subclinical cardiovascular diseases. Such deaths could be prevented and avoided if a greater regulatory sensitivity to the prevention and control of diving was encouraged, considering both the inherent risks of this activity and the possible unrecognized or underestimated pathologies.
在水肺潜水致命事故中,有必要区分原发性溺水死亡和主要由其他致病因素引起的继发性溺水死亡。水的吸入只能是一系列事件的终点,这一系列事件本身能够导致潜水员的退出。这项研究的目的是证明,即使是日常生活中低风险的心脏病,在潜水时也可能致命。方法:在本病例系列中,我们描述了巴里大学法医研究所在20年(2000-2020年)期间观察到的潜水过程中的所有死亡病例。对所有受试者进行司法尸检,并辅助进行组织学和毒理学调查。结果:在该综合医院开展的法医学调查结果确定,以严重心肌冠状动脉硬化为特征的4例心力衰竭合并急性心肌梗死为死亡原因,1例为无既往病理底物的受试者原发性溺水,1例为右心室功能过载引起的急性动态心力衰竭引起的终末期房颤。我们的研究表明,潜水期间的致命事件通常与未被识别或亚临床心血管疾病的存在有关。考虑到潜水活动的固有风险和可能未被认识或低估的病态,如果鼓励对预防和控制潜水活动有更大的监管敏感性,这种死亡是可以预防和避免的。
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引用次数: 0
Successful management of renal abscess secondary to diabetes mellitus with surgical treatment and hyperbaric oxygen therapy 糖尿病继发肾脓肿的外科治疗和高压氧治疗的成功治疗
IF 0.9 4区 医学 Q4 MARINE & FRESHWATER BIOLOGY Pub Date : 2023-01-01 DOI: 10.22462/01.01.2023.28
K. Yanagida, Daisuke Watanabe, Takahiro Yoshida, T. Nakagawa, A. Mizushima, K. Miura
Renal abscess (RA) is a collection of infective fluid in or around the renal parenchyma. It typically occurs in immunocompromised patients including those with diabetes mellitus (DM), poor nutritional status, or steroid administration. We herein report a case of RA associated with DM in which hyperbaric oxygen (HBO2) therapy greatly contributed to the resolution of this disease. The patient was an 85-year-old man with poorly controlled type 2 DM. Contrast-enhanced computed tomography for postoperative follow-up of appendiceal cancer showed a mass lesion with poor contrast enhancement extending from the upper pole of the left kidney to the dorsal side. Therefore, a diagnosis of RA was established. The lesion was percutaneously punctured and a drainage tube was placed. Antibiotics following sensitivity testing was administered. The catheter was removed six days after its placement. However, pus discharge continued from the catheter removal site, with persistent redness around the wound. Therefore, lumbotomy incision for abscess drainage was performed on the 49th day. However, the pus discharge persisted, and we decided to perform HBO2 therapy, expecting decreases in bacterial proliferation, reduction in local edema, and improvement of host defense. HBO2 therapy for 90 minutes at two atmosphere absolute was performed 10 times. The amount of pus discharge decreased and redness improved from the fifth day after HBO2 therapy. One month after starting HBO2 therapy, the wound was closed and pus discharge resolved completely. Four years have passed since the HBO2 therapy, and there have been no symptomatic or imaging relapses of RA.
肾脓肿(RA)是一种在肾实质内或周围的感染性积液。它通常发生在免疫功能低下的患者中,包括那些患有糖尿病(DM)、营养状况不良或服用类固醇的患者。我们在此报告一例RA合并DM,其中高压氧(HBO2)治疗极大地促进了这种疾病的解决。患者为85岁男性,患有控制不良的2型糖尿病。阑尾癌术后随访的增强计算机断层扫描显示从左肾上极延伸到肾背侧的肿块,增强效果不佳。因此,RA的诊断成立。经皮穿刺病变并放置引流管。药敏试验后给予抗生素。置管6天后取出。然而,拔管部位脓液继续排出,伤口周围持续发红。因此于第49天行腰腹切开引流脓肿。然而,脓流持续存在,我们决定进行HBO2治疗,期望减少细菌增殖,减少局部水肿,改善宿主防御。2大气压下90分钟HBO2治疗10次。HBO2治疗后第5天脓量减少,红肿改善。HBO2治疗1个月后伤口愈合,脓液完全排出。自HBO2治疗至今已有4年时间,没有出现RA的症状或影像学复发。
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Undersea and Hyperbaric Medicine
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