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.

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.

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.